La stadification (« staging ») endoscopique

Precise determination of mediastinal involvement in non-small-cell lung cancer has major therapeutic and prognostic implications. Although surgery remains the reference invasive technique, two new endoscopic techniques have been developed and have radically modified today's practices. Esophageal ultrasound (EUS) and endobronchial ultrasound (EBUS) are minimally invasive techniques that can be carried out under local anesthesia in an outpatient setting with no significant complications. It can guide needle aspiration of the mediastinal (hilar) lymph nodes in real time with excellent results, which positions these techniques as alternatives to surgery. Surgical mediastinal exploration remains indicated when the prevalence of mediastinal lymph node involvement is low or when EBUS and/or EUS is noninformative.