Related Experiment Video
Updated: Oct 6, 2025
05:22
Author Spotlight: Demonstrating Systematic Endobronchial Ultrasound to New Endoscopists
Published on: August 11, 2023
2.4K
Routine systematic sampling versus targeted sampling during endobronchial ultrasound: A randomized feasibility trial
Kerrie A Sullivan1, Forough Farrokhyar1, Grigorios I Leontiadis2
1Division of Thoracic Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.
The Journal of Thoracic and Cardiovascular Surgery
|January 15, 2022
Summary
Targeted sampling (TS) of lung cancer lymph nodes is as effective as systematic sampling (SS). This feasibility trial met progression criteria, supporting a larger Canadian study comparing TS and SS for lung cancer staging.
Area of Science:
- Pulmonology
- Oncology
- Medical Imaging
Background:
- Triple normal lymph nodes have a low malignancy risk (<6%).
- Current systematic sampling (SS) may be resource-intensive.
- Targeted sampling (TS) omits biopsy of triple normal nodes during endobronchial ultrasound.
Purpose of the Study:
- To assess if targeted sampling (TS) is a non-inferior staging strategy to systematic sampling (SS).
- To determine feasibility for a pan-Canadian trial comparing TS and SS in non-small cell lung cancer (NSCLC).
Main Methods:
- Prospective randomized feasibility trial in cN0-N1 NSCLC patients undergoing endobronchial ultrasound.
- Randomization to TS or SS; TS arm patients crossed over to SS.
- Progression criteria: recruitment rate (≥70%), procedure length, missed nodal metastasis (<6%).
Main Results:
- Trial met 70% recruitment early, triggering early stoppage.
- TS median procedure length was significantly shorter than SS (3.07 vs 19.07 minutes; P < .001).
- Missed nodal metastasis incidence in TS was 5.45%, below the 6% threshold.
Conclusions:
- Progression criteria for a larger pan-Canadian trial comparing TS and SS have been met.
- TS is a feasible and potentially more efficient lung cancer staging strategy.
- Further investigation in a noninferiority crossover trial is warranted.
