{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:31:59Z","timestamp":1769153519044,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives: The aim of the study was to compare the diagnostic efficiency between combined endobronchial ultrasound (EBUS)\/endoesophageal ultrasound (EUS) and transcervical extended mediastinal lymphadenectomy (TEMLA) for preoperative staging of mediastinal lymph nodes in non-small cell lung cancer (NSCLC). Material and Methods: Between June 2011 and December 2017, a single-institution prospective randomized trial was conducted, and 250 patients with cytologically confirmed NSCLC, clinical stages cI\u2013IIIA, were included. Positron emission tomography\/computed tomography (PET\/CT) was performed in all patients. After exclusions, 204 patients were randomized into the EBUS\/EUS or TEMLA arms. Patients without N2\/N3 metastases after mediastinal staging underwent surgery. The diagnostic yield and complication rates of the EBUS\/EUS and TEMLA groups were compared. Results: There were 103 patients in the EBUS\/EUS group, and N2 metastases were found in nine cases (8.7%). Ninety-four patients underwent surgery; in six cases, previously unsuspected N2 metastases were revealed. One hundred and one patients were randomized to the TEMLA group, which detected N2\/N3 metastases in 15 cases (15.1%). Three patients were not operated on due to postoperative complications following TEMLA. Eighty-three patients underwent surgery, and a single N2 metastatic nodule was detected in one case. The diagnostic sensitivity, specificity, accuracy, PPV, and NPV were 94%, 100%, 99%, 100%, and 99% for TEMLA, respectively, and 60%, 100%, 94%, 100%, and 94% for EBUS\/EUS, respectively. There was a significant difference in sensitivity (60% vs. 94%) between the EBUS\/EUS and TEMLA groups in favor of the TEMLA group. Postoperative complications occurred in 6\/101 (6%) patients after TEMLA, while no complications were observed in the EBUS\/EUS group. Conclusions: TEMLA demonstrated superior sensitivity for detecting N2\/3 disease compared to EBUS\/EUS in terms of diagnostic performance for mediastinal staging of cI\u2013IIIA NSCLC. Due to its more invasive nature, TEMLA was associated with a higher number of complications compared with EBUS\/EUS.<\/jats:p>","DOI":"10.3390\/cancers17132207","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T05:28:28Z","timestamp":1751347708000},"page":"2207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of the Diagnostic Efficiency of Mediastinal Lymph Node Endobronchial and Endoesophageal Ultrasound with Transcervical Extended Mediastinal Lymphadenectomy in Operable Non-Small Cell Lung Cancer"],"prefix":"10.3390","volume":"17","author":[{"given":"Michal","family":"Wilkojc","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawel","family":"Gwozdz","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylweriusz","family":"Kosinski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliusz","family":"Pankowski","sequence":"additional","affiliation":[{"name":"Department of Pathology, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artur","family":"Szlubowski","sequence":"additional","affiliation":[{"name":"Bronchoscopy Unit, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0118-7511","authenticated-orcid":false,"given":"Aleksandra","family":"Kiszka-Wilkojc","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, 31-531 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Czajkowski","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Kwiatkowski","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Katowice Center of Oncology, 31-531 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Zielinski","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Pulmonary Hospital, 34-500 Zakopane, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012","volume":"136","author":"Ferlay","year":"2015","journal-title":"Int. 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