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Prediction Models for Mediastinal Metastasis and Its Detection by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Potentially Operable Non-Small Cell Lung Cancer: A Prospective Study

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dc.contributor.author박소희-
dc.date.accessioned2024-03-22T06:08:22Z-
dc.date.available2024-03-22T06:08:22Z-
dc.date.issued2023-09-
dc.identifier.issn0012-3692-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/198418-
dc.description.abstractBackground: Prediction models for mediastinal metastasis and its detection by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) have not been developed using a prospective cohort of potentially operable patients with non-small cell lung cancer (NSCLC). Research Question: Can mediastinal metastasis and its detection by EBUS-TBNA be predicted with prediction models in NSCLC? Study Design and Methods: For the prospective development cohort, 589 potentially operable patients with NSCLC were evaluated (July 2016-June 2019) from five Korean teaching hospitals. Mediastinal staging was performed using EBUS-TBNA (with or without the transesophageal approach). Surgery was performed for patients without clinical N (cN) 2-3 disease by endoscopic staging. The prediction model for lung cancer staging-mediastinal metastasis (PLUS-M) and a model for mediastinal metastasis detection by EBUS-TBNA (PLUS-E) were developed using multivariable logistic regression analyses. Validation was performed using a retrospective cohort (n = 309) from a different period (June 2019-August 2021). Results: The prevalence of mediastinal metastasis diagnosed by EBUS-TBNA or surgery and the sensitivity of EBUS-TBNA in the development cohort were 35.3% and 87.0%, respectively. In PLUS-M, younger age (< 60 years and 60-70 years compared with ≥ 70 years), nonsquamous histology (adenocarcinoma and others), central tumor location, tumor size (> 3-5 cm), cN1 or cN2-3 stage by CT, and cN1 or cN2-3 stage by PET-CT were significant risk factors for N2-3 disease. Areas under the receiver operating characteristic curve (AUCs) for PLUS-M and PLUS-E were 0.876 (95% CI, 0.845-0.906) and 0.889 (95% CI, 0.859-0.918), respectively. Model fit was good (PLUS-M: Hosmer-Lemeshow P =.658, Brier score = 0.129; PLUS-E: Hosmer-Lemeshow P =.569, Brier score = 0.118). In the validation cohort, PLUS-M (AUC, 0.859 [95% CI, 0.817-0.902], Hosmer-Lemeshow P =.609, Brier score = 0.144) and PLUS-E (AUC, 0.900 [95% CI, 0.865-0.936], Hosmer-Lemeshow P =.361, Brier score = 0.112) showed good discrimination ability and calibration. Interpretation: PLUS-M and PLUS-E can be used effectively for decision-making for invasive mediastinal staging in NSCLC. Trial Registry: ClinicalTrials.gov; No.: NCT02991924; URL: www.clinicaltrials.gov © 2023 The Author(s)-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherAmerican College of Chest Physicians-
dc.relation.isPartOfCHEST-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAged-
dc.subject.MESHCarcinoma, Non-Small-Cell Lung* / diagnosis-
dc.subject.MESHCarcinoma, Non-Small-Cell Lung* / pathology-
dc.subject.MESHCarcinoma, Non-Small-Cell Lung* / surgery-
dc.subject.MESHEndoscopic Ultrasound-Guided Fine Needle Aspiration-
dc.subject.MESHHumans-
dc.subject.MESHLung Neoplasms* / pathology-
dc.subject.MESHLymph Nodes / pathology-
dc.subject.MESHLymphatic Metastasis / pathology-
dc.subject.MESHMediastinal Neoplasms* / pathology-
dc.subject.MESHMediastinum / pathology-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoplasm Staging-
dc.subject.MESHPositron Emission Tomography Computed Tomography-
dc.subject.MESHProspective Studies-
dc.titlePrediction Models for Mediastinal Metastasis and Its Detection by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Potentially Operable Non-Small Cell Lung Cancer: A Prospective Study-
dc.typeArticle-
dc.contributor.collegeGraduate School of Public Health (보건대학원)-
dc.contributor.departmentGraduate School of Public Health (보건대학원)-
dc.contributor.googleauthorHyun Sung Chung-
dc.contributor.googleauthorHo Il Yoon-
dc.contributor.googleauthorBin Hwangbo-
dc.contributor.googleauthorEun Young Park-
dc.contributor.googleauthorChang-Min Choi-
dc.contributor.googleauthorYoung Sik Park-
dc.contributor.googleauthorKyungjong Lee-
dc.contributor.googleauthorWonjun Ji-
dc.contributor.googleauthorSohee Park-
dc.contributor.googleauthorGeon Kook Lee-
dc.contributor.googleauthorTae Sung Kim-
dc.contributor.googleauthorHyae Young Kim-
dc.contributor.googleauthorMoon Soo Kim-
dc.contributor.googleauthorJong Mog Lee-
dc.identifier.doi10.1016/j.chest.2023.03.041-
dc.contributor.localIdA01531-
dc.relation.journalcodeJ00520-
dc.identifier.eissn1931-3543-
dc.identifier.pmid37019355-
dc.subject.keywordEBUS-TBNA-
dc.subject.keywordmediastinal staging-
dc.subject.keywordnon-small cell lung cancer-
dc.subject.keywordprediction model-
dc.contributor.alternativeNamePark, So Hee-
dc.contributor.affiliatedAuthor박소희-
dc.citation.volume164-
dc.citation.number3-
dc.citation.startPage770-
dc.citation.endPage784-
dc.identifier.bibliographicCitationCHEST, Vol.164(3) : 770-784, 2023-09-
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers

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