Less-Invasive Method Finds Stage of Lung Cancer
Study Shows Patients May Not Need Surgical Procedure to Learn the Stage of Their Lung Cancer
Comparing Staging Techniques continued...
The new strategy, he says, also reduces the number of unnecessary incisions into the chest wall (thoracotomies). The number of unnecessary thoracotomies was 21 (18%) of the surgical staging group compared to nine (7%) of the ultrasound-first group.
Complication rates were similar. Most common, the researchers found, was persistent hoarseness.
"'The conclusion is, if you stage patients according to the new strategy and do endosonography first, then surgical staging, you significantly detect more spread of the disease," he says, while reducing the number of unnecessary chest incisions.
The expertise of the doctor performing the ultrasound is a critical factor, says Mark D. Iannettoni, MD, MBA, department chair of cardiothoracic surgery and executive director of the Heart and Vascular Center, University of Iowa Hospitals and Clinics, Iowa City, who wrote an editorial to accompany the study.
The ultrasound techniques used to stage lung cancer, he tells WebMD, are typically done by different doctors -- either a gastroenterologist, pulmonologist, or thoracic (chest) surgeon.
The findings of the new study, he tells WebMD, may eventually be good news for some patients. If the ultrasound is positive, the doctor can decide on treatment. But if it's negative, ''it still needs to be staged surgically."
"This is the first step," he says of the study, ''in collecting enough data to show eventually you won't have to use surgical staging at all."
But he says the surgical staging will remain ''the gold standard" for now, until more data is in and until all patients are cared for at specialized centers, increasing the likelihood of doctors well-versed in the ultrasound procedures.
For patients hoping to undergo ultrasound first, he says a doctor's skill remains crucial. "You have to make sure you have someone who has enough expertise so that the results are reliable and reproducible." That means finding a doctor who specializes, performing perhaps three or four of the ultrasound techniques each day, Iannettoni says.