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In this regard, the debate of cases in MDT sessions is crucial for optimal management of patients. Current evidence\u2010based clinical guidelines for preoperative NSCLC staging recommend that mediastinal staging should be performed with increasing invasiveness. Image\u2010based techniques are the first approach, although they have limited accuracy and findings must be confirmed by pathology in almost all cases. In this setting, the advent of radiomics is promising. Invasive staging depends on procedural factors rather than diagnostic performance. The choice between endoscopy\u2010based or surgical procedures should depend on the local expertise of each centre. As the extension of mediastinal disease in terms of number of involved lymph nodes and nodal stations affects prognosis and the choice of treatment, systematic samplings are preferred over random targeted samplings. Following this approach, a diagnosis of single mediastinal nodal involvement can be unreliable if all reachable mediastinal nodal stations have not been assessed. The performance of confirmatory mediastinoscopy after a negative endoscopy\u2010based procedure is controversial but currently recommended. Current indications of invasive staging in patients with radiologically normal mediastinum have to be re\u2010evaluated, especially for central tumour location.<\/jats:p>","DOI":"10.1111\/resp.13901","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T02:56:43Z","timestamp":1594609003000},"page":"37-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Preoperative staging of the mediastinum is an essential and multidisciplinary task"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8354-414X","authenticated-orcid":false,"given":"Jos\u00e9","family":"Sanz\u2010Santos","sequence":"first","affiliation":[{"name":"Department of Pulmonology, Hospital Universitari M\u00fatua Terrassa University of Barcelona  Terrassa Spain"},{"name":"Department of Medicine, Medical School University of Barcelona  Barcelona Spain"},{"name":"Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group  Terrassa Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergi","family":"Call","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Hospital Universitari M\u00fatua Terrassa University of Barcelona  Terrassa Spain"},{"name":"Department of Morphological Sciences, Medical School Autonomous University of Barcelona  Cerdanyola Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.09.025"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31820b88a7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu028"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2355"},{"key":"e_1_2_9_6_1","unstructured":"National Comprehensive Cancer Network. 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