EUS-FNA in the Pre-Operative Evaluation of Patients With Lung Cancer

Inclusion Criteria: patients with histological or cytological proof of non small cell lung cancer (NSCLC) or with a high clinical suspicion for lung cancer (but without pathologically confirmed diagnosis from the bronchoscopy or CT guided transthoracal biopsies) in whom the next step is normally a diagnostic or therapeutic surgical intervention no distant metastases after routine clinical work up (PET is optional, not mandatory) provision of a written informed consent recent CT-scan of the thorax (<28 days before randomization date) age 18 years or older clinically fit for surgery Exclusion Criteria: proof of small cell lung cancer (SCLC) with CWU (bronchoscopy or CT guided transthoracal punction) stage IV NSCLC patients with a solitary pulmonary nodule (thus without enlarged mediastinal lymph nodes on CT and without mediastinal PET hot spots) : these do not require further mediastinal investigation former therapy (chemotherapy or radiotherapy or surgery) for lung cancer other concomitant malignancies reasons for which the patient is unable to swallow the EUS-instrument (e.g. zenker diverticulum, unexplained esophageal stenosis) uncorrected coagulopathy