Endobronchial and esophageal ultrasound for lung tumor diagnosis and staging

The aim of this thesis was to further explore the role of endosonography in the diagnosis and staging of lung cancer with a focus on lung tumor diagnosis and assessment of tumor invasion.
In Part 1 (chapters 1-5) titled Endobronchial and esophageal ultrasound for diagnosing lung tumors, we evaluated the diagnostic accuracy and safety of endosonography (EBUS, EUS-B and EUS) in obtaining a tissue diagnosis in lung tumors located adjacent to the major airways and the esophagus. First, a systematic review and meta-analysis regarding EBUS for diagnosing central lung tumors was performed. Second, the role of EBUS, EUS-B and EUS for diagnosing centrally located lung tumors located near or adjacent to the major airways, respectively the esophagus was evaluated. Third, two cases of atrial tumors are presented diagnosed by endosonography. In the final chapter of this part, a protocol of an ongoing randomized controlled trial comparing two different EBUS needles was presented.
In part 2 titled Endobronchial and esophageal ultrasound for T staging of Lung tumors (chapters 6 and 7) the role of EBUS and EUS for assessing the T4 status (e.g. lung tumor invasion in the mediastinum or central vessels) in patients with lung cancer was evaluated, as well as its added value to CT-scan of the chest.
Part 3 is titled Novel lung cancer staging strategies and its impact on survival (chapter 8). The 5 year survival rates of lung cancer patients are discussed of patients that were initially staged by endosonography vs those that underwent immediate surgical staging.