ASSESSMENT OF MEDIASTINAL LYMPH-NODE INVOLVEMENT

The analysis of extension to mediastinal lymph nodes during the initial assessment of primary bronchial cancers relies on computed tomography, MRI and mediastinoscopy. Two reports of the consensus conference analysed the respective sensitivity and specificity of these three techniques. The impact of these examinations on the survival of the patients undergoing them is difficult to measure. The successive introduction of these techniques into daily practice has not been analysed in terms of impact on survival. Randomized studies in homogeneous groups of patients of the influence of examinations such as mediastinoscopy on survival are lacking today. While computed tomography has become essential, mainly because it is easy to use and allows re-reading, mediastinoscopy remains an examination for which the indications are controversial according to the schools.