![]() Mediastinal and hilar lymph node (LN) involvement determines N, which could be assessed by noninvasive approaches, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) scan, and by invasive meanings, including mediastinoscopy, transbronchial needle aspiration (TBNA) and trans-esophageal fine needle aspiration (TENA). Hence, early detection and accurate staging is no doubt significant and closely related to disease outcome. However, up to 75% of patients with lung cancer present with symptoms due to locally advanced or metastatic disease, who are not amenable to cure ( 3). ![]() Even within stage, metastatic spread of cancer to distant organs is the cause for most cancer deaths, which is estimated via N and M descriptor in TNM staging system. The prognosis of lung cancer is directly related to its stage at the time of diagnosis. But even worse, the enormous burden constituted by lung cancer has shifted to less developed countries, which are currently responsible for about 58% of cases and 61% of lung cancer deaths ( 2). Although a good number of progress has been achieved in lung cancer management, including diagnostic approaches, biomarkers and treatments, lung cancer is still hard to be diagnosed until advanced stages, leading to a 17% 5-year overall survival rate according to the latest cancer statistics ( 1). ![]() Lung cancer is the leading cause of cancer related morbidity and mortality among men and women worldwide. Keywords: Lymph node (LN) metastasis lung cancer computed tomography (CT) positron emission tomography-computed tomography (PET-CT) transbronchial needle aspiration (TBNA) Hence, we highlight the importance of comprehensive estimation of mediastinal and hilar LNs, and we suggested the judgment of LNs by radiographic tools alone might not be reliable and TBNA is indispensable in certain circumstances. Additionally, radiographic features including ground-glass/solid nodules ratio, referring as imaging biomarker, were indicated to be correlated with metastasis. Furthermore, transbronchial needle aspiration (TBNA) with and without endobronchial ultrasound (EBUS), as a well-accepted minimally invasive approach for LN biopsy, has been documented as an efficient tool in evaluation of CT and PET-CT negative LNs. Subsequently, positron emission tomography-computed tomography (PET-CT) was shown to be superior to CT alone on assessment of nodal involvement and was widely used to estimate suitability for resection with curative intent, but the dependability also remains controversial. Early studies have suggested lymph nodes (LNs) >1.0 cm in size on computed tomography (CT) are considered as metastatic nodes, while the sensitivity of this criterion is not satisfied. However, the process is usually beyond complex. Interviews with Outstanding Guest EditorsĪbstract: Accurate determination of the diagnosis and the stage of lung cancer play a critical role to ensure that patients are provided the optimal treatment. ![]() Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process. ![]()
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