Invasive staging of lung cancer by mediastinoscopy and video-assisted thoracoscopy

Accurate evaluation of the outcomes of clinical trials using preoperative chemotherapy in a multimodality treatment protocol may require invasive pretreatment staging for pathologic confirmation of the clinical TNM. Mediastinoscopy and videothoracoscopy complement each other to provide appropriate staging of lung cancer. Invasive staging utilizing both methods may accurately determine the presence or absence of N2 and N3 disease, and identify T3 or T4 or thoracic M1 disease.