COMPARISON OF PET-CT AND ENDOBRONCHIAL ULTRASOUND WITH SURGICAL HISTOPATHOLOGY FOR MEDIASTINAL NODAL STAGING OF NON-SMALL CELL LUNG CANCER IN PATIENTS UNDERGOING SURGERY

Lung cancer is the leading cause of cancer (globally) incidence and mortality, accounting for an estimated 2 million diagnoses and 1.8 million deaths and also leading cause of cancer mortality worldwide.

After initial diagnosis of NSCLC patients undergo for staging with PETCT as the treatment of NSCLC depending on the stage of the disease includes surgical resection with curative intent in early-stage disease and chemoradiation in advanced stage disease. For surgically resect-able cases EBUS is done to stage mediastinum to exclude mediastinal lymph-nodal involvement because for N2 disease there are two options of treatment either definitive chemo-radiation or NACT/NACTRT followed by assessment and surgery for selected patients. For mediastinal staging both the above mentioned tests have its own drawbacks. Studies show when both tests are  used together , a better staging of mediastinum is followed. As EBUS-TBNA may identify additional malignant LNs (7.4%), and this highlights the risk for false-negative findings with PET scanning in isolation. Also there are stations (like station 5/6/8/9) where EBUS cant sample.

The study aims to see the accuracies of PET-CT and EBUS  when they are compared to post-surgical histopathological examination report. Thus this study will provide sensitivity, specificity , positive and negative predictive value of both the tests and how these tests contribute to proper mediastinal staging.