REPEAT MEDIASTINOSCOPY IN THE STAGING OF LUNG-CANCER

Objective: Despite technical difficulties due to mediastinal fibrosis, repeat mediastinoscopy can be a valuable tool in the restaging of lun g cancer. It provides essential pathological information on mediastina l invasion when selecting patients for surgical resection after induct ion chemotherapy in stage ma disease. The aim of our study was to eval uate the feasibility, sensitivity and accuracy of repeat mediastinosco py. Methods: From 1994 to 1997 we performed a repeat mediastinoscopy i n 15 patients (13 men, two women) with bronchogenic carcinoma. Their a ge ranged from 49 to 75 years. (mean 64.7). Seven patients had inducti on chemotherapy for a nonsmall cell bronchogenic carcinoma with positi ve N2 nodes on mediastinoscopy. Four patients had a second primary con tralateral lung cancer, one had a locoregional recurrence of bronchoge nic carcinoma. The other three had a first mediastinoscopy for other r easons than lung cancer, repeat mediastinoscopy being performed for st aging of malignant disease. Results: In all 15 patients it was possibl e to perform a complete repeat mediastinoscopy. In one patient repeat mediastinoscopy turned out to be false negative, so, in our series, se nsitivity was 87.5%, specificity 100% and accuracy 93.7%. Conclusion: Previous mediastinoscopy is no contraindication for a repeat one. Repe at mediastinoscopy offers valuable pathological information in restagi ng of lung cancer. (C) 1998 Elsevier Science B.V. All rights reserved.