{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:44:30Z","timestamp":1787071470469,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:p>Mediastinal staging is a crucial factor in the decision making in patients with non-metastatic non-small cell lung cancer (NSCLC). Mediastinoscopy has historically been the gold standard for this purpose. With the advent of PET-CT, the role of an invasive staging modality like mediastinoscopy has been diminishing. Newer developments in endoscopic staging like EBUS and EUS-FNA have also provided means to get a cytological diagnosis of enlarged lymph nodes. With the meta-analyses showing encouraging results of neoadjuvant chemotherapy in operable lung cancers including the early stage disease, the sanctity of invasive mediastinal staging for the sole purpose for selecting patients for upfront surgery is debatable. This article discusses the various modalities for mediastinal staging in NSCLC. We also present our perspective regarding the need for a balanced approach between the accuracy of mediastinal staging, invasiveness of the staging modalities, and alternate staging methods. With the liberal use of neoadjuvant chemotherapy in operable NSCLC, the role of invasive mediastinal staging procedures is likely to get limited further, giving way to non-invasive staging modalities like PET-CT.<\/jats:p>","DOI":"10.4103\/0019-509x.219579","type":"journal-article","created":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T00:43:22Z","timestamp":1513817002000},"page":"68-72","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Mediastinal staging for non-small cell lung cancer revisited. It is being done under aegis of ICON and Lung cancer consortium asia"],"prefix":"10.4103","volume":"54","author":[{"given":"D","family":"Pandey","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Prabhash","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,12,1]]},"reference":[{"key":"R2-20250920","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.7314\/APJCP.2012.13.4.1547","article-title":"First data on direct costs of lung cancer management in Morocco","volume":"13","author":"Tachfouti","year":"2012","journal-title":"Asian Pac J Cancer Prev"},{"key":"R3-20250920","doi-asserted-by":"crossref","first-page":"e211S","DOI":"10.1378\/chest.12-2355","article-title":"Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"143","author":"Silvestri","year":"2013","journal-title":"Chest"},{"key":"R4-20250920","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.ejrad.2010.03.027","article-title":"MSCT multi-criteria: A novel approach in assessment of mediastinal lymph node metastases in non-small cell lung cancer","volume":"79","author":"Volterrani","year":"2011","journal-title":"Eur J Radiol"},{"key":"R5-20250920","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ejrad.2010.09.001","article-title":"Diffusion-weighted MR imaging in comparison to integrated [18F]-FDG PET\/CT for N-staging in patients with lung cancer","volume":"81","author":"Pauls","year":"2012","journal-title":"Eur J Radiol"},{"key":"R6-20250920","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1183\/09031936.00119106","article-title":"Detection of extrapulmonary lesions with integrated PET\/CT in the staging of lung cancer","volume":"29","author":"De Wever","year":"2007","journal-title":"Eur Respir J"},{"key":"R7-20250920","doi-asserted-by":"crossref","first-page":"3743","DOI":"10.7314\/APJCP.2013.14.6.3743","article-title":"Staging with PET-CT in patients with locally advanced non small cell lung cancer is superior to conventional staging methods in terms of survival","volume":"14","author":"Mutlu","year":"2013","journal-title":"Asian Pac J Cancer Prev"},{"key":"R8-20250920","doi-asserted-by":"crossref","first-page":"879","DOI":"10.7326\/0003-4819-139-11-200311180-00013","article-title":"Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: A meta-analysis","volume":"139","author":"Gould","year":"2003","journal-title":"Ann Intern Med"},{"key":"R9-20250920","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/ejcts\/ezr272","article-title":"False-negative rate after positron emission tomography\/computer tomography scan for mediastinal staging in cI stage non-small-cell lung cancer","volume":"42","author":"G\u00f3mez-Caro","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"R10-20250920","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1378\/chest.109.4.982","article-title":"Evaluation of pulmonary lesions with FDG-PET. 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