Division of Thoracic Surgery, Toronto General Hospital, Toronto, ON.
Curr Oncol. 2011 Dec;18(6):e304-10. doi: 10.3747/co.v18i6.820.
In non-small-cell lung cancer (nsclc), invasive mediastinal staging is typically used to guide treatment decision-making. Here, we present clinical practice guideline recommendations for invasive mediastinal staging in nsclc patients who have been staged T1-4, N0-3, with no distant metastases.
Draft recommendations were formulated based on the best available evidence gathered by a systematic review and a consensus of expert opinion. The draft recommendations underwent an internal review by clinical and methodology experts, and an external review by clinical practitioners through a survey assessing the clinical relevance and overall quality of the guideline. Feedback from the internal and external reviews was integrated into the clinical practice guideline.
In general, most clinical experts agreed with the guideline, approving it for methodologic rigour. More than 80% of the surveyed practitioners gave it a high quality rating. The expert reviewers also provided written comments, with some of the suggested changes being incorporated into the final version of the guideline.
In the clinical practice guideline, invasive mediastinal staging of nsclc is recommended in all cases except those involving patients with normal-sized lymph nodes, negative combine positron-emission tomography and computed tomography, and peripheral clinical stage 1A tumour. When performing mediastinoscopy, 5 nodal stations (2R/L, 4R/L, and 7) should routinely be examined.
在非小细胞肺癌（nsclc）中，通常使用侵袭性纵隔分期来指导治疗决策。在这里，我们提出了适用于 T1-4、N0-3、无远处转移的 nsclc 患者的侵袭性纵隔分期的临床实践指南建议。
根据系统评价和专家共识收集的最佳可用证据制定了建议草案。这些建议草案经过临床和方法学专家的内部审查，并通过一项评估指南临床相关性和整体质量的调查，由临床医生进行外部审查。内部和外部审查的反馈意见被纳入临床实践指南。
一般来说，大多数临床专家都同意该指南，认为其方法学严谨性良好。超过 80%的调查医生给予了该指南高质量评分。专家评审员还提供了书面意见，其中一些建议的更改被纳入了指南的最终版本。
在临床实践指南中，除了那些涉及正常大小淋巴结、阴性结合正电子发射断层扫描和计算机断层扫描以及周围临床 1A 期肿瘤的患者外，建议对所有 nsclc 患者进行侵袭性纵隔分期。在行纵隔镜检查时，应常规检查 5 个淋巴结站（2R/L、4R/L 和 7）。
