Restaging patients with N2 non-small cell lung cancer after neoadjuvant therapy: TCMS accuracy using a multi-criteria approach

An appropriate staging of lung cancer is critical, because stage dictates treatment and treatment regimens vary considerably according to the stage. The involvement of mediastinal lymph nodes has long been recognized as the most important prognostic factor in non-metastatic non-small cell lung cancer (NSCLC). It is very important to correctly identify preoperative patients with N2 disease (stage IIIA), because for these patients surgery should be avoided offering instead a multimodality approach [4]. Computed tomography (CT) is the method of choice in the preoperative staging of patients with NSCLC. In the CT assessment of mediastinal lymph nodes the majority of the studies use the size of the node as the only criterion suggestive of malignancy, thus limiting the usefulness of such method in comparison with PET. Considering our previous study on this topic, the aim of this work has been to evaluate the accuracy of MDCT in restaging patients with N2 NSCLC, after neoadjuvant chemotherapy using a multi-criteria approach.