EUS-FNA in the Pre-Operative Evaluation of Patients With Lung Cancer

Inclusion Criteria:

• patients with histological or cytological proof of non small cell lung cancer (NSCLC) or with a high clinical suspicion for lung cancer (but without pathologically confirmed diagnosis from the bronchoscopy or CT guided transthoracal biopsies) in whom the next step is normally a diagnostic or therapeutic surgical intervention
• no distant metastases after routine clinical work up (PET is optional, not mandatory)
• provision of a written informed consent
• recent CT-scan of the thorax (<28 days before randomization date)
• age 18 years or older
• clinically fit for surgery

Exclusion Criteria:

• proof of small cell lung cancer (SCLC) with CWU (bronchoscopy or CT guided transthoracal punction)
• stage IV NSCLC
• patients with a solitary pulmonary nodule (thus without enlarged mediastinal lymph nodes on CT and without mediastinal PET hot spots) : these do not require further mediastinal investigation
• former therapy (chemotherapy or radiotherapy or surgery) for lung cancer
• other concomitant malignancies
• reasons for which the patient is unable to swallow the EUS-instrument (e.g. zenker diverticulum, unexplained esophageal stenosis)
• uncorrected coagulopathy