Thread by @biniamkidaneMD

1/ i was afraid you were hanging your argument on this calculation from @DrAlexLouie (of whom I’m a fan) but this is irrelevant to our current discussions...for so many reasons. Most importantly, these numbers are for clinical stage 1 #lungcancer not our 6cm cN0 mass #tssmn

https://twitter.com/drewmoghanaki/status/1340813506036330496

2/all cancers meeting guideline criteria for invasive mediastinal staging are usually not clinical stage 1 & thus your numbers (even if we accept them as being valid) do not apply. #tssmn

3/most importantly however, these patients with N2 disease are not allowed to get best therapy for their stage upfront (ie systemic therapy). Mediastinal staging is all about how to get #lungcancer patients to the best first therapy (ie neoadjuvant vs upfront local Rx) #tssmn

4/finally,it’s illogical to malign existing guidelines as being based on outdated/irrelevant data while in the next breath invoking data from an era even older than that which you are maligning.
I say this in spirit of respect & friendship➡️I’m happy to be corrected if I’ve erred

@threadreaderapp please unroll