Which definition of central tumour is more predictive of occult mediastinal metastasis in non-small cell lung cancer patients with radiologic N0 disease?

What is it about?

Accurate mediastinal staging is an essential step in the management of patients with non-small cell lung cancer (NSCLC) without distant metastasis. Lung cancer guidelines recommend invasive mediastinal staging for centrally located tumors, even in cases without evidence of mediastinal metastasis (radiologic N0 disease). However, there is no uniform definition of central tumour. We evaluated seven different definitions of central tumour in 1,337 consecutive patients with radiologic N0 disease who underwent invasive mediastinal staging. Only the central tumour definition of inner one-third of the hemithorax by concentric lines arising from the midline was associated with mediastinal metastasis. We suggest that central tumour should be defined using the inner one-third of the hemithorax adopted by drawing concentric lines from the midline.

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