Piskorskyi O. The Role of Cervical Mediastinoscopy in the Diagnosis and Treatment of Lung Cancer

The dissertation studies the diagnostic capabilities of invasive and non-invasive methods for lung cancer diagnosis, searching for the optimal algorithm of their use. The study aims to improve the diagnosis and treatment of lung cancer by widespread use of cervical mediastinoscopy, introducing its optimal application algorithm. The relevance of the research topic is driven by the annual increase in the incidence and mortality rates of lung cancer patients. Every year, approximately 1.6 million new cases are registered worldwide. Lung cancer continues to be the leading cause of oncological mortality. Early diagnosis plays a crucial role in management of this pathology, as it allows for timely and personalized treatment onset. In the diagnosis of lung cancer, both non-invasive and invasive diagnostic methods are used. Among the main non-invasive methods are computed tomography and positron emission tomography, which allow for the detection, as well as estimating the spread and localization of the pathology. These methods are applied in the initial stage of diagnostic screening, and help determine the invasive methods, performed with morphological verification purposes. Among the used invasive methods are transbronchial needle aspiration, cervical mediastinoscopy, thoracoscopy, and open biopsy. Since the correct assessment of mediastinal lymph nodes is crucial in the diagnosis and choice of treatment strategies for lung cancer, there is an ongoing need for improved diagnosis of lymph node involvement, which determines staging, treatment, and prognosis of lung cancer. The study included 112 lung cancer patients ranging in age from 19 to 81 years old. From the obtained results, it was found that out of the 112 patients, 69 (61.6%) had tumors in the right lung, while 43 (38.4%) had tumors in the left lung. The average age of the lung cancer patients was 60.5 ± 9.5 years. Depending on the applied diagnostic methods, all patients were divided into five groups: Group I - 112 patients who underwent computed tomography during the diagnosis of lung cancer; Group II - 27 patients who underwent positron emission tomography during the diagnosis of lung cancer; Group III - 23 patients who underwent transbronchial needle aspiration under endobronchial ultrasound during the diagnosis of lung cancer; Group IV - 89 patients who underwent cervical mediastinoscopy during the diagnosis of lung cancer and examination of mediastinal lymph nodes; Group V - 33 patients who had mediastinal lymph nodes removed intraoperatively, preceded by either cervical mediastinoscopy or transbronchial needle aspiration under endobronchial ultrasound.