Guidelines for mediastinal staging of lung cancer

http://www.ncbi.nlm.nih.gov/pubmed/22184498

Curr Oncol. 2011 Dec;18(6):e304-10.
Invasive mediastinal staging of non-small-cell lung cancer: a clinical practice guideline.
Darling GE, Dickie AJ, Malthaner RA, Kennedy EB, Tey R.
Source
Division of Thoracic Surgery, Toronto General Hospital, Toronto, ON.

Abstract
INTRODUCTION:
In non-small-cell lung cancer (nsclc), invasive mediastinal staging is typically used to guide treatment decision-making. Here, we present clinical practice guideline recommendations for invasive mediastinal staging in nsclc patients who have been staged T1-4, N0-3, with no distant metastases.
METHODS:
Draft recommendations were formulated based on the best available evidence gathered by a systematic review and a consensus of expert opinion. The draft recommendations underwent an internal review by clinical and methodology experts, and an external review by clinical practitioners through a survey assessing the clinical relevance and overall quality of the guideline. Feedback from the internal and external reviews was integrated into the clinical practice guideline.
RESULTS:
In general, most clinical experts agreed with the guideline, approving it for methodologic rigour. More than 80% of the surveyed practitioners gave it a high quality rating. The expert reviewers also provided written comments, with some of the suggested changes being incorporated into the final version of the guideline.
CONCLUSIONS:
In the clinical practice guideline, invasive mediastinal staging of nsclc is recommended in all cases except those involving patients with normal-sized lymph nodes, negative combine positron-emission tomography and computed tomography, and peripheral clinical stage 1A tumour. When performing mediastinoscopy, 5 nodal stations (2R/L, 4R/L, and 7) should routinely be examined.