The Annals of Thoracic Surgery, Vol 20, 678-686, Copyright © 1975 by The Society of Thoracic Surgeons
Is mediastinoscopy necessary in the evaluation of lung cancer?
NH Fishman and MH Bronstein
The records of 96 consecutive patients who underwent mediastinoscopy and
were ultimately shown to have bronchogenic carcinoma were reviewed.
Indirect tests for mediastinal tumor metastases in these patients included
bronchoscopy and chest roentgenograms in all 96, mediastinal laminagrams in
65, esophagograms in 27, carinal biopsy in 23, bronchograms in 5, pulmonary
angiograms in 5, azygograms in 2, and aortograms in 2 patients. Of the 43
patients in this series in whom all indirect tests revealed no metastases,
mediastinoscopy showed nodal involvement in 11 (28%), who were thus spared
unnecessary thoracotomy. On the other hand, if negative mediastinoscopy had
not cast doubt on the validity of indirect tests that seemed to show
metastases, an operation might actuallly have been denied to 14 patients
who were ultimately proved to have anatomically resectable disease.
