From the Guidelines
VAM, or Video-Assisted Mediastinoscopy, is a diagnostic technique used in lung cancer staging to assess mediastinal lymph nodes, particularly when other methods like EBUS or EUS are negative or inconclusive, as it offers a high negative predictive value to rule out mediastinal lymph node disease 1.
Key Points About VAM in Lung Cancer Diagnostics
- VAM is indicated when there is a high clinical suspicion of mediastinal lymph node involvement but EBUS and/or EUS do not reveal nodal involvement 1.
- It is particularly useful for ruling out mediastinal lymph node disease due to its high negative predictive value 1.
- The procedure involves the insertion of a video-assisted scope into the mediastinum to visually examine and potentially biopsy lymph nodes or other tissues.
- VAM can be crucial in the staging of non-small cell lung cancer (NSCLC), helping to differentiate between locally advanced but potentially resectable tumors and those that are unresectable.
Clinical Application and Recommendations
- In clinical practice, VAM should be considered as part of a comprehensive staging workup for NSCLC, especially in cases where less invasive staging methods are inconclusive or when there is a high suspicion of mediastinal involvement 1.
- The choice between VAM and other staging methods like EBUS/EUS should be based on local expertise, patient factors, and the specific clinical scenario.
- Given its invasive nature, VAM is typically reserved for situations where the information gained could significantly alter treatment planning, such as in potentially resectable cases or when assessing for mediastinal spread.
Evidence and Guidelines
- The European Society for Medical Oncology (ESMO) clinical practice guidelines for the diagnosis, treatment, and follow-up of NSCLC support the use of VAM in specific clinical contexts, particularly when other staging methods are negative or not feasible 1.
- Other guidelines, such as those from the National Comprehensive Cancer Network (NCCN), may also address the role of VAM in lung cancer staging, though the specifics can depend on the guideline version and the clinical scenario in question 1.
From the Research
VAM in Lung Cancer Diagnostics
- VAM stands for Vessel Assessment Method, however, there is no direct information available in the provided studies about VAM in lung cancer diagnostics.
- The studies provided focus on various aspects of lung cancer diagnosis, including imaging techniques such as CT and PET scans 2, 3, 4, histological classification 5, and the importance of early diagnosis 6.
- The use of CT scans and PET scans are discussed in detail, highlighting their role in detecting and staging lung cancer, as well as their limitations 3, 4.
- The studies also emphasize the importance of histological classification and molecular testing in lung cancer diagnosis 2, 5.
- However, none of the studies mention the Vessel Assessment Method (VAM) specifically, suggesting that it may not be a widely recognized or established method in lung cancer diagnostics 2, 3, 4, 5, 6.