Role of thoracoscopic lymph node staging for lung and esophageal cancer.

Staging is extremely important in determining the proper treatment of patients with thoracic malignancies. Staging groups can be used to predict outcome after cancer treatment and allocate patients to appropriate treatment regimens. Thoracoscopy is an excellent means of staging intrathoracic malignancies. It is a good tool for biopsy of mediastinal lymph nodes and evaluation of the pleural cavity. Routine thoracoscopic and laparoscopic lymph node staging have been used in patients with esophageal carcinoma with excellent results. For patients with lung cancer, thoracoscopy augments other noninvasive and minimally invasive staging procedures. It is used as a complement to standard cervical mediastinoscopy in assessing mediastinal and hilar lymph nodes. It can thus help avoid an unnecessary thoracotomy for attempted resection in a patient who is found to have gross spread of locoregional disease.