{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T16:16:53Z","timestamp":1649089013900},"reference-count":0,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>The exclusion of pathological involvement of mediastinal lymph nodes in patients affected by NSCLC plays a central role in assessing\u00a0 their prognosis and operability. Ceron et al. developed a software - called M.E.S.S.i.a (Mediastinal Evaluation with Statistical Support; instant approach) - that allows the calculation of the residual probability of lymph node involvement after a certain number of tests has been done, by integrating every test result with the pre-test prevalence. M.E.S.S.i.a. bridges a gap of current American College of Chest Physicians (ACCP) guidelines, providing probability values of mediastinal metastasis for a correct clinical decision. We conducted a preliminary retrospective study in a series of 108 patients affected by non small cell lung cancer (NSCLC). Pathological staging was compared to the probability of nodal involvement calculated by M.E.S.S.i.a. software. Forty-two out of 108 subjects (39%) had a calculated post-test probability &lt;8%; none of these had proven N2\/N3 metastasis at surgical staging (negative predictive value, NPV: 100%). In 12\/41 cases M.E.S.S.i.a. was able to avoid invasive procedures. The remaining 66 (61%) patients did not reach the surgical threshold; among these, 11 displayed N2 positivity at pathological staging. Receiving operator curve (ROC) analysis produced an area under curve (AUC) value of\u00a0 0.773 (p&lt;0.001). These preliminary data show high accuracy of M.E.S.S.i.a. software in excluding N2\/N3 lymph node involvement in NSCLC. We have therefore promoted a prospective multicenter study in order to to get a validation of the calculator at different levels of probability of lymph node involvement. The recruitable subjects are potentially operable NSCLC patients; the gold standard for detection of mediastinal disease is the surgical lymph node dissection.<\/jats:p>","DOI":"10.4081\/monaldi.2019.1068","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T21:48:36Z","timestamp":1568152116000},"source":"Crossref","is-referenced-by-count":0,"title":["Statistical approach to mediastinal staging in NSCLC with M.E.S.S.i.a. software"],"prefix":"10.4081","volume":"89","author":[{"given":"Thomas","family":"Galasso","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Corbetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mancino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucio","family":"Michieletto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loris","family":"Ceron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2019,9,10]]},"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/download\/1068\/940","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/download\/1068\/940","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T19:53:46Z","timestamp":1585252426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/view\/1068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,10]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,9,10]]}},"URL":"https:\/\/doi.org\/10.4081\/monaldi.2019.1068","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2019,9,10]]}}}