Abstract:

Objective: The aim of this study is to observe what has changed in the indications and outcomes of cervical mediastinoscopy (CM) as a result of advancements in the technology and diagnostic methods over the years. Materials and Methods: A total of 1071 patients, diagnosed with primary non small cell lung cancer (NSCLC) were evaluated retrospectively. CM was indicated in 454 patients (Group 1) out of 610 NSCLC patients between years 2003-2005, whereas 261 patients (Group 2) out of 461 NSCLC patients between years 2017-2019. After exclusions, 195 patients in Group 1 and 194 patients in Group 2 underwent surgery. We compared two groups in terms of CM indications, detection of clinic multiple N2, N3 and single-station cN2 disease with CM, unexpected pathologic (p)N2 ratios and false negativity of CM. Results: There were 454 of 610 patients (74.4%) in Group 1 and 261 of 461 patients (56.6%) in Group 2 were indicated with CM (p<0.001). While 78 patients (17.2%) in Group 1 were diagnosed with multiple clinics N2, N3 with CM, 4 patients (1.5%) in Group 2 (p <0.001). Single-station cN2 was detected in 18 patients (4%) in Group 1 and 27 patients (10.3%) in Group 2 (p = 0.001). While 45 patients (23.1%) had unexpected pN2 in Group 1, it was found in 18 patients (9.3%) in Group 2 (p <0.001). False negativity found in 17 patients (8.7%) in Group 1, whereas 8 patients (4.1%) in Group 2 (0.065). A statistically significant difference was found between the groups in terms of CM indications, diagnosis of clinic multiple N2, cN3, single-station cN2 and detection of unexpected pN2. Conclusion: Over the years, as a result of advancements in technology and minimally invasive techniques, cervical mediastinoscopy indications, clinical multiple N2, cN3 disease detection with CM, unexpected pN2 detection in surgery and false negativity ratios of CM have decreased.

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