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Staging lung cancer: METHODS OF STAGING (5)

CXR: Except when gross adenopathy is identified, CXR does not adequately assess lymph node spread. Gross mediastinal adenopathy noted on plain CXR is associated with an extremely poor prognosis, with three-year survival averaging 9% . Biopsy confirmation of metastatic involvement is required.

CT: CT is currently the most effective noninvasive method of assessing possible mediastinal lymph node metastases . CT evidence of adenopathy is usually nodes with a short axis diameter (1.0 cm). A meta-analysis of CT accuracy in defining mediastinal node involvement ascribed a sensitivity of 79%, a specificity of 78% and an overall accuracy of 80% . Between 5% and 30% of ‘abnormal’ nodes are positive for cancer, while as many as 15% of patients with ‘normal’ nodes are positive . The false negative rate increases in the presence of adenocarcinoma, large cell tumours and with all central T3 cancers . Thus, surgical resectability cannot be excluded solely on the basis of CT evidence of adenopathy, and, by the same token, certain lesions are associated with increased risk of mediastinal nodal involvement despite a ‘negative’ CT. It’s your turn to benefit from the shopping whenever you need efficient order alegra that will be sure to work for your problem. This is now all very much possible at the best online pharmacy you have ever come across offering it services to you and other international customers interested.

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