PMID- 31505918
OWN - NLM
STAT- MEDLINE
DCOM- 20200218
LR  - 20200218
IS  - 1122-0643 (Print)
IS  - 1122-0643 (Linking)
VI  - 89
IP  - 3
DP  - 2019 Sep 10
TI  - Statistical approach to mediastinal staging in NSCLC with M.E.S.S.i.a. software.
LID - 10.4081/monaldi.2019.1068 [doi]
AB  - The exclusion of pathological involvement of mediastinal lymph nodes in patients 
      affected by NSCLC plays a central role in assessing  their prognosis and 
      operability. Ceron et al. developed a software - called M.E.S.S.i.a (Mediastinal 
      Evaluation with Statistical Support; instan approach) - that allows the 
      calculation of the residual probability of lymph node involvement after a certain 
      number of tests has been done, by integrating every test result with the pre-test 
      prevalence. M.E.S.S.i.a. bridges a gap of current American College of Chest 
      Physicians (ACCP) guidelines, providing probability values of mediastinal 
      metastasis for a correct clinical decision. We conducted a preliminary 
      retrospective study in a series of 108 patients affected by non small cell lung 
      cancer (NSCLC). Pathological staging was compared to the probability of nodal 
      involvement calculated by M.E.S.S.i.a. software. Forty-two out of 108 subjects 
      (39%) had a calculated post-test probability <8%; none of these had proven N2/N3 
      metastasis at surgical staging (negative predictive value, NPV: 100%). In 12/41 
      cases M.E.S.S.i.a. was able to avoid invasive procedures. The remaining 66 (61%) 
      patients did not reach the surgical threshold; among these, 11 displayed N2 
      positivity at pathological staging. Receiving operator curve (ROC) analysis 
      produced an area under curve (AUC) value of  0.773 (p<0.001). These preliminary 
      data show high accuracy of M.E.S.S.i.a. software in excluding N2/N3 lymph node 
      involvement in NSCLC. We have therefore promoted a prospective multicenter study 
      in order to to get a validation of the calculator at different levels of 
      probability of lymph node involvement. The recruitable subjects are potentially 
      operable NSCLC patients; the gold standard for detection of mediastinal disease 
      is the surgical lymph node dissection.
FAU - Galasso, Thomas
AU  - Galasso T
AD  - Pulmonology Unit, Santa Croce Hospital, Fano. thomas.galasso123@gmail.com.
FAU - Corbetta, Lorenzo
AU  - Corbetta L
FAU - Mancino, Laura
AU  - Mancino L
FAU - Michieletto, Lucio
AU  - Michieletto L
FAU - Ceron, Loris
AU  - Ceron L
LA  - eng
PT  - Journal Article
DEP - 20190910
PL  - Italy
TA  - Monaldi Arch Chest Dis
JT  - Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace
JID - 9307314
SB  - IM
MH  - Aged
MH  - Area Under Curve
MH  - Carcinoma, Non-Small-Cell Lung/*secondary
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*pathology
MH  - Lymph Nodes/*pathology
MH  - Lymphatic Metastasis
MH  - Male
MH  - Mediastinum
MH  - Multicenter Studies as Topic
MH  - Neoplasm Staging/*statistics & numerical data
MH  - Preliminary Data
MH  - Probability
MH  - Prospective Studies
MH  - ROC Curve
MH  - Retrospective Studies
MH  - *Software
MH  - Validation Studies as Topic
EDAT- 2019/09/12 06:00
MHDA- 2020/02/19 06:00
CRDT- 2019/09/12 06:00
PHST- 2019/03/24 00:00 [received]
PHST- 2019/07/24 00:00 [accepted]
PHST- 2019/09/12 06:00 [entrez]
PHST- 2019/09/12 06:00 [pubmed]
PHST- 2020/02/19 06:00 [medline]
AID - 10.4081/monaldi.2019.1068 [doi]
PST - epublish
SO  - Monaldi Arch Chest Dis. 2019 Sep 10;89(3). doi: 10.4081/monaldi.2019.1068.