Original Abstract
PURPOSE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is essential for mediastinal staging in non-small cell lung cancer (NSCLC), yet uniform lymph node (LN) size criteria for sampling remain unvalidated. METHODS: This single-center retrospective study evaluated consecutive patients who underwent EBUS-TBNA for initial staging of NSCLC with available PET-CT were included. Nonparametric tests compared LN sizes across mediastinal stations 4R, 4L, and 7. RESULTS: Among 205 patients (median age 69 years), 1,306 LNs were analyzed, including 770 nodes ≥5 mm and 449 mediastinal LNs. Significant size variation was observed across stations in benign nodes (p < 0.001), particularly between 4R or 4L versus 7, while malignant nodes did not differ significantly (p = 0.065). CONCLUSIONS: These findings suggest that uniform LN size cutoffs for EBUS-TBNA may not be optimal across mediastinal stations. Prospective, multicenter validation is warranted to refine evidence-based criteria for EBUS-guided mediastinal staging.