Many @entity1 with early stage @entity2 (stage I and II) are curable by surgical resection. In @entity1 with locally advanced disease surgery plays an important role in order to provide @entity5 control. Therefore, the aim of all staging efforts in NSCLC must be to identify all @entity1 , who might be potential candidates for a surgical approach. Current staging tools include imaging techniques like CT- and PET-scan, transthoracic, transbronchial or transeosophageal needle biopsies and finally surgical staging methods including mediastinoscopy and video-assisted thoracoscopic surgery (VATS). With respect to mediastinal lymph node staging, cervical mediastinoscopy is reported to have a sensitivity between 81 and 89%. This mainly due to the fact, that some lymph node levels (# 8, 9, 5, 6) are not accessible by the standard cervical approach. The morbidity and mortality of cervical mediastinoscopy is in experienced centers only minimal. In series with more than 1000 @entity1 , the mortality was almost 0% and morbidity varied between 0.5 and 1%. Cervical mediastinoscopy can be performed also as an outpatient procedure. In addition to 'simple' lymph node staging, mediastinoscopy clarifies the local resectability of central @entity5 (T-factor). Currently, cervical mediastinoscopy is recommended by almost all scientific societies in @entity1 with apparently resectable NSCLC who present with enlarged mediastinal lymph nodes of >1 cm in short axis diameter. Video-mediastinoscopy allows that the procedure gets even more standardized and preliminary data suggest that the sensitivity might be improved in comparison to conventional mediastinoscopy. Since VATS is widely accepted by the community of thoracic surgeons, it has become an important staging tool in many situations. VATS can be used to rule out or confirm a suspected contralateral lung metastasis. Furthermore, VATS is extremely useful to exclude @entity3483 in otherwise operable @entity1 . This examination can be done in the operating room immediately prior to formal thoracotomy. Additionally, VATS is effective to explore the local resectability in @entity1 with suspected mediastinal infiltration or a lymphangiosis carcinomatosa within the mediastinum. VATS allows an accurate staging of more than 90% of the @entity1 with suspected stage IIIB NSCLC. With respect to lymph node staging, VATS is complimentary to cervical mediastinoscopy because it helps to stage the lymph nodes in the A-P. window (#5, 6), as well as the lymph nodes paraesophageal (#8) and in the pulmonary ligament (#9). In conclusion, surgical staging methods provide a 100% specificity in combination with a high sensitivity and only a minimal morbidity. Currently, surgical staging is recommended by the majority of scientific societies for the staging of @entity1 with apparently resectable NCSLC.

Initial surgical XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['local tumor', 'tumors'] @entity3483 :: ('MESH:D016066', 'Disease') :: ['malignant pleural effusions']
@entity5 :: (MESH:D009369,Disease) :: ['staging of lung cancer']
