Chest
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Randomized Controlled Trial
Endobronchial Ultrasound Staging of Operable NSCLC: Do Triple Normal Lymph Nodes Require Routine Biopsy?
Staging guidelines for lung cancer recommend endobronchial ultrasound (EBUS) and systematic biopsy of at least three mediastinal lymph node (LN) stations for accurate staging. A four-point ultrasonographic score (Canada Lymph Node Score [CLNS]) was developed to determine the probability of malignancy in each LN. A LN with a CLNS of < 2 is considered low probability for malignancy. We hypothesized that, in patients with cN0 non-small cell lung cancer, LNs with CLNS of < 2 may not require routine biopsy because they represent true node-negative disease. ⋯ At the time of staging for lung cancer, combining CT scanning, PET scanning, and CLNS criteria can identify triple-normal LNs that have a high NPV for malignancy. This raises the question of whether triple-normal LNs require routine sampling during EBUS and transbronchial needle aspiration. A prospective trial is required to confirm these findings.
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Letter Randomized Controlled Trial
Psychological Symptoms Among Surrogates of Critically Ill Patients During and Before the COVID-19 Pandemic.