ORIGINAL ARTICLES: PDF OnlyMediastinal Assessment for Staging of Lung Cancer Computerized Tomography and Cervical MediastinoscopyKristensen, SSren M.D.Φ; Aaby, Carsten M.D.; Nielsen, Stig MSller M.D.*Φ; Petersen, Ulrik M.D.†Author Information Departments of Otolaryngology, University Hospital. Aarhus. Denmark * Radiology, Central Hospital, Exbjerg, University Hospital. Aarhus. Denmark † Department of Otolaryngology—Head and Neck Surgery, University Hospital. Aarhus. Denmark Journal of Bronchology: April 1995 - Volume 2 - Issue 2 - p 123-129 Free Abstract The exact indications for computed tomography (CT) of the thorax and mediastinoscopy (MS) in lung cancer (LC) still remain incompletely defined. The present study was designed to establish a standard approach to cervical MS for otolaryngologists, who in Denmark traditionally are involved in the staging of LC. Seventy-eight clinically resectable patients with LC routinely underwent CT of the chest prior to bronchoscopy and cervical MS. Sixty-four patients had non-small cell LC and 14 patients had small cell LC. Cervical MS alone established the histological diagnosis in 19% of the patients. In diagnosing metastases in the superior mediastinum, a criterion of 10 mm for abnormal enlargement of lymph node size resulted in an overall specificity and sensitivity of mediastinal CT of 85 and 81%, respectively. No clinicopathological characteristics could be identified to influence the accuracy of CT, except for the finding that the rate of false-negative mediastinal CT was significantly higher in females than in males. It was demonstrated that mediastinal lymph nodes in patients with mediastinal metastases were significantly larger than mediastinal lymph nodes in patients without metastases. It is concluded that because of the unsatisfactorily low specificity and sensitivity of mediastinal CT, cervical MS remains essential in the evaluation of patients with presumed or verified LC and that cervical MS, in experienced hands, is a safe and accurate procedure. For otolaryngologists. the strategy of routine cervical MS, performed under general anesthesia in the same stage as bronchoscopy. is advocated as a standard approach to mediastinal assessment for the staging of LC. © Williams & Wilkins 1995. All Rights Reserved.