Mediastinal Staging of Lung Cancer With EBUS-TBNA and EUS-B-FNA

Minimally Invasive Mediastinal Staging of Potentially Operable Lung Cancer With Endobronchial Ultrasound Guided Transbronchial Needle Aspiration(EBUS-TBNA) and Transesophageal Aspiration Using Ultrasonic Bronchoscope (EUS-B-FNA)

The purpose of this study is to find a role of EUS-B-FNA in the mediastinal staging of potentially operable lung cancer. The investigators perform EBUS-TBNA and EUS-B-FNA on potentially operable lung cancer patients. The investigators perform EBUS(+/- TBNA) and EUS-B (ultrasonographic examination through the esophagus) on all subjects. EUS-B-FNA will be performed on inaccessible nodes or difficult nodes to be sampled by EBUS-TBNA. Additional diagnostic values of EUS-B-FNA as compared to EBUS-TBNA alone will be estimated.

Inclusion Criteria:

• Histologically confirmed or strongly suspected potentially operable non-small cell lung cancer (NSCLC)
• Potentially operable patients

Exclusion Criteria:

After staging work-up for NSCLC, including bronchoscopy,CT of the chest and upper abdomen, integrated PET/CT and brain MRI (and/or bone scan)

• M1 disease
• Inoperable T4 disease
• Mediastinal infiltration or extranodal invasion of the mediastinal lymph node visible on chest CT.
• Confirmed supraclavicular lymph node metastasis
• Pancoast tumors
• Medically inoperable patients
• Contraindications for bronchoscopy