1
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Li D, Li Z, Li S, Zhang H, Yao S, Li Y, Chen J. Development and Validation of a Prediction Model for Positive Findings of Preoperative Flexible Bronchoscopy in Patients with Peripheral Lung Cancer. Curr Oncol 2022; 30:315-325. [PMID: 36661674 PMCID: PMC9858296 DOI: 10.3390/curroncol30010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
(1) Background: It has yet to be determined whether preoperative flexible bronchoscopy (FB) should be routinely performed in patients with peripheral lung cancer. The aim of this study was to construct a model to predict the probability of positive FB findings, which would help assess the necessity of preoperative FB. (2) Methods: A total of 380 consecutive patients with peripheral lung cancer who underwent preoperative FB were recruited for this study. A prediction model was developed through univariate and multivariate logistic regression, with predictors including gender, age, body mass index (BMI), smoking, history of chronic lung diseases, respiratory symptoms, lesion size, lesion type, lesion location in the bronchi, and lesion location in the lobe. The predictive performance of the model was evaluated by validation using 1000 iterations of bootstrap resampling. Model discrimination was assessed using the area under the receiver operating characteristics curve (AUC), and calibration was assessed using the Brier score and calibration plots. (3) Results: The model suggested that male patients with respiratory symptoms, decreased BMI, solid lesions, and lesions located in lower-order bronchi were more likely to have positive FB findings. The AUC and Brier score of the model for internal validation were 0.784 and 0.162, respectively. The calibration curve for the probability of positive FB findings showed convincing concordance between the predicted and actual results. (4) Conclusions: Our prediction model estimated the pretest probability of positive FB findings in patients with peripheral lung cancers. Males and patients with lower BMI, the presence of respiratory symptoms, larger lesions, solid lesions, and lesions located in lower-order bronchi were associated with increased positive FB findings. The use of our model can be of assistance when making clinical decisions about preoperative FB.
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Affiliation(s)
- Dongyu Li
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
- Yuncheng Central Hospital, Yuncheng 044000, China
| | - Zaishan Li
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Shaolei Li
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Hongbing Zhang
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Siqing Yao
- Yuncheng Central Hospital, Yuncheng 044000, China
| | - Yi Li
- Yuncheng Central Hospital, Yuncheng 044000, China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
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2
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Zhang Y, Chen H. Lung cancer screening: who pays? who receives?-the Chinese perspective. Transl Lung Cancer Res 2021; 10:2389-2394. [PMID: 34164286 PMCID: PMC8182701 DOI: 10.21037/tlcr.2020.03.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The National Lung Screening Trial (NLST) revealed that low-dose computed tomography (LDCT) screening reduced lung cancer mortality by 20.0%. In China, LDCT is very cheap and easy to access. As a result, LDCT screening is not limited to "high-risk" population defined by the NLST trial. The results of LDCT screening in China are also quite different from that in Western countries. LDCT detected lung cancer in a significant proportion of young, female and non-smokers in China. There is also a higher proportion of adenocarcinoma (ADC), a lower proportion of squamous cell carcinoma, and a higher proportion of early-stage 0/I disease among LDCT-detected lung cancer in China. The issue of overdiagnosis and overtreatment is discussed. Finally, we call the global attention to clarify the etiology of lung cancer in young female non-smokers.
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Affiliation(s)
- Yang Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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3
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Ye T, Chen Z, Ma D, Chen S, Xia G, Zhang Y, Li H, Zhang Y, Luo X, Miao L, Ma L, Sun Y, Pan Y, Hu H, Zhang Y, Xiang J, Shao L, Wu H, Li B, Huang Q, Ma X, Zheng D, Zheng S, Yuan C, Yu T, Lu Y, Li Y, Li Q, Gu Y, Wang S, Ge D, Gu J, Zhu F, Zhang J, Wang F, Weng Y, Jia C, Liu S, Xing W, Lin K, Tang S, Qian B, Hsin M, Chen H. Is flexible bronchoscopy necessary in the preoperative workup of patients with peripheral cT1N0 subsolid lung cancer? -a prospective multi-center cohort study. Transl Lung Cancer Res 2021; 10:1635-1641. [PMID: 34012780 PMCID: PMC8107749 DOI: 10.21037/tlcr-20-1122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Necessity of flexible bronchoscopy (FB) examination as a routine preoperative work-up for peripheral clinical T1N0 subsolid lung cancer was unknown. Methods This was a prospective, multi-center clinical trial (NCT03591445). Patients with peripheral GGO nodules (GGNs) who were candidates for surgical resection were enrolled. FB examination was performed preoperatively. Surgical plan could be changed if any aberrant histologic and anatomic findings were detected by FB examination. Primary endpoint was the rate that surgical plan was changed by positive FB findings. Secondary endpoints were rate of positive FB findings and rate of procedural complications. Results Six hundred and fifteen patients with peripheral subsolid nodules detected by thoracic CT were enrolled. There were 187 (30.4%) male and 428 (69.6%) female patients, mean age was 54.85±10.41 y (range, 26-78). 262 (42.6%) patients had pure GGNs and 353 (57.4%) patients had part-solid nodules. Mean size of nodules was 13.87±6.37 mm (range, 5-30). FB examinations confirmed one (0.16%) adenocarcinoma, seven (1.14%) bronchial variations, one (0.16%) segmental bronchostenosis, one (0.16%) segmental bronchial occlusion and one (0.16%) bronchial inflammation. No complications of FB examinations occurred. 568 (92.35%) thoracoscopic and 47 (7.65%) open surgeries were performed. No established surgical plan was changed by positive FB findings. Final pathologies revealed 26 (4.2%) adenocarcinoma in situ (AIS), 240 (39%) minimal invasive adenocarcinomas (MIAs), 343 (55.8%) invasive adenocarcinomas (IADs), one (0.2%) adenosquamous cell carcinoma, one (0.2%) squamous cell carcinoma, two (0.3%) atypical adenoid hyperplasia and two (0.3%) inflammations. Conclusions FB examination was unnecessary in the preoperative assessment of peripheral clinical T1N0 subsolid lung cancer.
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Affiliation(s)
- Ting Ye
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | | | | | - Sufeng Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Guozhan Xia
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yiliang Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hang Li
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yang Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoyang Luo
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Longsheng Miao
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Longfei Ma
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yihua Sun
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yunjian Pan
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hong Hu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yawei Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaqing Xiang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Longlong Shao
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Haoxuan Wu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bin Li
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qingyuan Huang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao Ma
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Difan Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shanbo Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chongze Yuan
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tao Yu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yunyun Lu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuan Li
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qiao Li
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yajia Gu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Shengping Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Di Ge
- Shanghai Zhongshan Hospital, Shanghai, China
| | - Jie Gu
- Shanghai Zhongshan Hospital, Shanghai, China
| | - Feng Zhu
- Anhui Chest Hospital, Hefei, China
| | - Jingshun Zhang
- Guanxian Central Hospital of Shandong Province, Liaocheng, China
| | - Fudong Wang
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yuan Weng
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Chunyi Jia
- Jilin Provincial Tumor Hospital, Jilin, China
| | | | | | - Kaihong Lin
- The Third People's Hospital of Jieyang, Jieyang, China
| | - Shaoqing Tang
- The Third People's Hospital of Jieyang, Jieyang, China
| | - Bin Qian
- Jiangdu People's Hospital of Yangzhou Jiangsu Province, Yangzhou, China
| | - Michael Hsin
- Queen Mary Hospital of Hongkong, Hongkong, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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4
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Zhang Y, Fu F, Chen H. Management of Ground-Glass Opacities in the Lung Cancer Spectrum. Ann Thorac Surg 2020; 110:1796-1804. [PMID: 32525031 DOI: 10.1016/j.athoracsur.2020.04.094] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/27/2020] [Accepted: 04/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of lung ground-glass opacity (GGO) lesions are detected. This review focuses on lung adenocarcinoma manifesting as GGO. METHODS We performed a literature search of the PubMed/MEDLINE database to identify articles reporting GGO. The following terms were used: GGO, ground-glass opacity, GGN, ground-glass nodule, part-solid nodule, and subsolid nodule. RESULTS GGO is a nonspecific radiologic finding showing a hazy opacity without blocking underlying pulmonary vessels or bronchial structures. The pathology of GGO can be benign, preinvasive, or invasive adenocarcinoma. Although radiographic features may indicate malignancy, a short period of follow-up is the optimal method to distinguish between benign and malignant GGO lesions. Pathologically, not only lepidic, but also nonlepidic growth patterns can present as GGO. Lung adenocarcinoma with a GGO component is associated with excellent survival compared with solid lesions. Moreover, there are distinct prognostic factors in patients with lung adenocarcinoma manifesting as GGO or solid lesions. For selected GGO-featured lung adenocarcinoma, sublobar resection with selective or no mediastinal lymph node dissection may be sufficient. Intraoperative frozen section is an effective method to guide resection strategy. A less intensive postoperative surveillance strategy may be more appropriate given the excellent survival. Management of multiple GGO lesions requires comprehensive considerations of GGO characteristics and patient conditions. CONCLUSIONS Lung adenocarcinoma manifesting as GGO defines a special clinical subtype with excellent prognosis. The management of GGO-featured lung adenocarcinoma should be distinct from that of solid lesions.
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Affiliation(s)
- Yang Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Institute of Thoracic Oncology, Fudan University, Shanghai, China; State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fangqiu Fu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Institute of Thoracic Oncology, Fudan University, Shanghai, China; State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Institute of Thoracic Oncology, Fudan University, Shanghai, China; State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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5
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Zhang Y, Jheon S, Li H, Zhang H, Xie Y, Qian B, Lin K, Wang S, Fu C, Hu H, Zheng Y, Li Y, Chen H. Results of low-dose computed tomography as a regular health examination among Chinese hospital employees. J Thorac Cardiovasc Surg 2019; 160:824-831.e4. [PMID: 31987625 DOI: 10.1016/j.jtcvs.2019.10.145] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Lung cancer is traditionally more prevalent in the elderly patients, men, and smokers. However, as low-dose computed tomography (LDCT) is increasingly popular, we hypothesized the disease spectrum might change. METHODS LDCT was performed as a part of regular health examinations in 8392 of 15,686 employees from 6 hospitals in different regions of China in 2012 to 2018. Clinicopathologic characteristics, including age, sex, smoking status, radiologic features, tumor histology, and pathologic stage, were retrospectively analyzed. RESULTS LDCT incidentally detected lung cancer (pathologically confirmed) in a total of 179 (2.1%) hospital employees. The lung cancer detection rate was significantly greater in female than male (2.5% vs 1.3%, P = .001) patients. There was also a greater detection rate among nonsmokers than smokers, although statistical significance was not reached (2.2% vs 1.4%, P = .092). The lung cancer detection rate was 1.0% in the "age ≤40 years" group, 2.6% in the "40 < age ≤55 years" group, and 2.9% in the "age >55 years" group (P < .001). Among the hospital employees with lung cancer, 171 (95.5%) presented as ground-glass opacity, 177 (98.9%) were lung adenocarcinoma, 170 (95.0%) were early stage 0/IA, and 177 (98.9%) received curative surgical resection as the initial treatment. After a median follow-up of 38 months, no disease recurrence or death was observed among these patients. CONCLUSIONS LDCT detected lung cancer in a significant proportion of young, female, and nonsmoking employees. The vast majority of these lung cancers were early stage, with extremely good prognosis.
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Affiliation(s)
- Yang Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Huimin Li
- Department of Radiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huibiao Zhang
- Department of Thoracic Surgery, Huadong Hospital Fudan University, Shanghai, China
| | - Yaozeng Xie
- Medical Imaging Division, Liaocheng Second People's Hospital, Linqing, Liaocheng, Shandong Province, China
| | - Bin Qian
- Department of Thoracic Surgery, Jiang du People's Hospital of Yangzhou City, Yangzhou, China
| | - Kaihong Lin
- Department of Surgical Oncology, People's Hospital of Jieyang Industrial Transfer Park, Guangdong, China
| | - Shengping Wang
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chen Fu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hong Hu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Ying Zheng
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuan Li
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Institute of Biomedical Sciences, Fudan University, Shanghai, China; State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.
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6
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Stokstad T, Sørhaug S, Amundsen T, Grønberg BH. Reasons for prolonged time for diagnostic workup for stage I-II lung cancer and estimated effect of applying an optimized pathway for diagnostic procedures. BMC Health Serv Res 2019; 19:679. [PMID: 31533705 PMCID: PMC6751647 DOI: 10.1186/s12913-019-4517-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 09/09/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Minimizing the time until start of cancer treatment is a political goal. In Norway, the target time for lung cancer is 42 days. The aim of this study was to identify reasons for delays and estimate the effect on the timelines when applying an optimal diagnostic pathway. METHODS Retrospective review of medical records of lung cancer patients, with stage I-II at baseline CT, receiving curative treatment (n = 100) at a regional cancer center in Norway. RESULTS Only 40% started treatment within 42 days. The most important delays were late referral to PET CT (n = 27) and exercise test (n = 16); repeated diagnostic procedures because bronchoscopy failed (n = 15); and need for further investigations after PET CT (n = 11). The time from referral to PET CT until the final report was 20.5 days in median. Applying current waiting time for PET CT (≤7 days), 48% would have started treatment within 42 days (p = 0.254). "Optimal pathway" was defined as 1) referral to PET CT and exercise test immediately after the CT scan and hospital visit, 2) tumor board discussion to decide diagnostic strategy and treatment, 3) referral to surgery or curative radiotherapy, 4) tissue sampling while waiting to start treatment. Applying the optimal pathway, current waiting time for PET CT and observed waiting times for the other procedures, 80% of patients could have started treatment within 42 days (p < 0.001), and the number of tissue sampling procedures could have been reduced from 112 to 92 (- 16%). CONCLUSION Changing the sequence of investigations would significantly reduce the time until start of treatment in curative lung cancer patients at our hospital and reduce the resources needed.
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Affiliation(s)
- Trine Stokstad
- Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, PO Box 8905, MTFS, NO-7491, Trondheim, Norway. .,Department of Gynecology, St. Olavs hospital, Trondheim University Hospital, PO Box 3250, Sluppen, NO-7006, Trondheim, Norway.
| | - Sveinung Sørhaug
- Faculty of Medicine and Health Sciences, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, PO Box 8905, MTFS, NO-7491, Trondheim, Norway.,Department of Thoracic Medicine, St. Olavs hospital, Trondheim University Hospital, PO Box 3250, Sluppen, NO-7006, Trondheim, Norway
| | - Tore Amundsen
- Faculty of Medicine and Health Sciences, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, PO Box 8905, MTFS, NO-7491, Trondheim, Norway.,Department of Thoracic Medicine, St. Olavs hospital, Trondheim University Hospital, PO Box 3250, Sluppen, NO-7006, Trondheim, Norway
| | - Bjørn H Grønberg
- Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, PO Box 8905, MTFS, NO-7491, Trondheim, Norway.,Cancer Clinic, St. Olavs hospital, Trondheim University Hospital, PO Box 3250, Sluppen, NO-7006, Trondheim, Norway
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7
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刘 宝. [Diagnosis and Treatment of Pulmonary Ground-glass Nodules]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2019; 22:449-456. [PMID: 31315784 PMCID: PMC6712268 DOI: 10.3779/j.issn.1009-3419.2019.07.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/06/2019] [Accepted: 03/10/2019] [Indexed: 12/19/2022]
Abstract
Recent widespread use of high resolution computed tomography (HRCT) for the screening of lung cancer have led to an increase in the detection rate of very faint and smaller lesions known as ground-glass nodule (GGN). However, it had been proved that GGN was well associated with lung cancer in previous studies. Therefore, the classification, imaging characteristics, pathological type, follow-up, suggested managements and other clinical concerns of GGN were reviewed in this paper.
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Affiliation(s)
- 宝东 刘
- />100053 北京,首都医科大学宣武医院胸外科Department of Toracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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8
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Forbearance With Bronchoscopy. Chest 2019; 155:834-847. [DOI: 10.1016/j.chest.2018.08.1035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/01/2018] [Accepted: 08/06/2018] [Indexed: 02/06/2023] Open
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9
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Zhuge L, Huang Y, Wang S, Xie J, Huang B, Zheng D, Zheng S, Zhao Y, Mao H, Wilson DO, Luketich JD, Xiang J, Chen H, Zhang J. Preoperative brain MRI for clinical stage IA lung cancer: is routine scanning rational? J Cancer Res Clin Oncol 2018; 145:503-509. [PMID: 30536037 PMCID: PMC6373267 DOI: 10.1007/s00432-018-2814-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/04/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Early detection and control of lung cancer brain metastases (BMs) are important. However, several guideline recommendations are inconsistent with regard to routine preoperative brain MRI, especially in patients with clinical stage IA lung cancer. Our study evaluated the value of preoperative brain MRI in patients with clinical stage IA lung cancer. METHODS A retrospective analysis of patients with lung cancer was performed using a prospectively collected database. Clinical data and the results of brain MRI were collected and analyzed. RESULTS Patients with pathologically proved primary lung cancer who underwent an MRI at initial diagnosis were identified (3392 patients). In total, 170 patients (5.0%) were diagnosed with BMs. The increased frequency of BMs was significantly associated with advanced clinical stage (P = 0.000) and pathological type (P = 0.011). BMs were detected in 11 out of 1595 patients with clinical stage IA lung cancer (0.7%). BMs were more common in patients with clinical stage cT1c lung cancer (1.9%) than those with clinical stage cT1a or cT1b (0.1%, odds ratio = 21.30, 95% confidence interval: 2.7-166.9, P = 0.000). All patients with stage IA lung cancer and BMs had solid lung lesions (P = 0.002). CONCLUSIONS Preoperative brain MRI might help identify BMs in patients with lung cancer that has progressed beyond stage IA. In patients with clinical stage IA lung cancer, we do not recommend preoperative brain MRI, but it may potentially be beneficial in those with solid T1c cancers.
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Affiliation(s)
- Lingdun Zhuge
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yangle Huang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Shengfei Wang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Juntao Xie
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Binhao Huang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Difan Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Shanbo Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yue Zhao
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Hengyu Mao
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - David O Wilson
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - James D Luketich
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Jiaqing Xiang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Jie Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.
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10
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Jiang G, Chen C, Zhu Y, Xie D, Dai J, Jin K, Shen Y, Wang H, Li H, Zhang L, Gao S, Chen K, Zhang L, Zhou X, Shi J, Wang H, Xie B, Jiang L, Fan J, Zhao D, Chen Q, Duan L, He W, Zhou Y, Liu H, Zhao X, Zhang P, Qin X. [Shanghai Pulmonary Hospital Experts Consensus on the Management of Ground-Glass Nodules Suspected as Lung Adenocarcinoma (Version 1)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:147-159. [PMID: 29587930 PMCID: PMC5973030 DOI: 10.3779/j.issn.1009-3419.2018.03.05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
随着胸部计算机断层扫描(computed tomography, CT)检查,尤其是低剂量薄层CT筛查项目在中国的广泛开展,越来越多的无症状肺部磨玻璃结节(ground-glass nodules, GGNs)被发现。虽然国内及国际上已发布了一系列针对肺部GGNs的指南,但是这些指南的撰写者多来自呼吸、肿瘤及影像专业,可能缺乏对现代微创胸外科的充分认识,造成外科手术在肺部GGNs诊治中的作用不明确,甚至被低估;而且,肺部肿瘤相关的各学科对于早期肺癌,尤其是浸润前病变的处理也缺乏统一规范。因此,基于国内外现有文献及上海市肺科医院多年积累的经验,上海市肺科医院撰写了此诊疗共识。本共识推荐对于疑似肺腺癌的GGNs进行多学科评估,依据诊断,选择合理的处置方式。对于疑似原位腺癌,推荐进行胸部薄层CT随访,或在特定情况下进行不超过肺段切除的限制性肺切除;对于疑似微浸润腺癌,推荐进行限制性肺切除或肺叶切除;对于疑似浸润性腺癌,建议依据病灶是否含有磨玻璃成分、位置、大小、个数及患者躯体情况选择合理的手术方式;而肺多发结节的处理原则推荐为主病灶优先,兼顾次要病灶,综合选择治疗方案。
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Affiliation(s)
- Gening Jiang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Chang Chen
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Yuming Zhu
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Dong Xie
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Jie Dai
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Kaiqi Jin
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Yingran Shen
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Haifeng Wang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Hui Li
- Capital Medical University Affiliated Beijing Chao-Yang Hospital, Beijing 100020 , China
| | - Lanjun Zhang
- Sun Yat-sen University Cancer Center, Guangzhou 510060 , China
| | - Shugeng Gao
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Keneng Chen
- Peking University Cancer Hospital and Institute, Beijing 100142 , China
| | - Lei Zhang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Xiao Zhou
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Jingyun Shi
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Hao Wang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Boxiong Xie
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Lei Jiang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Jiang Fan
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Deping Zhao
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Qiankun Chen
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Liang Duan
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Wenxin He
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Yiming Zhou
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Hongcheng Liu
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Xiaogang Zhao
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Peng Zhang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Xiong Qin
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
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11
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Zheng D, Chen H. Lung cancer screening in China: early-stage lung cancer and minimally invasive surgery 3.0. J Thorac Dis 2018; 10:S1677-S1679. [PMID: 30034835 DOI: 10.21037/jtd.2018.05.206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Difan Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai 200032, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai 200032, China
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12
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Lu R, Mei J, Zhao D, Jiang Z, Xiao H, Wang M, Ma N. Concomitant thoracoscopic surgery for solitary pulmonary nodule and atrial fibrillation. Interact Cardiovasc Thorac Surg 2018; 26:402-406. [PMID: 29136152 DOI: 10.1093/icvts/ivx346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/25/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection. METHODS Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation. A modified epicardial radiofrequency ablation combined with pulmonary vein isolation, circumferential left atrial ablation, ganglionic plexus ablation and left atrial appendage resection was performed for all patients. Left pulmonary surgery was carried out subsequently. RESULTS The mean procedure duration was 203.1 ± 15.6 (range 177-224) min. All patients successfully underwent this procedure with no conversion to sternotomy or pacemaker implantation. Of the 16 included patients, 13 received lobectomy and 3 received wedge resection. No severe complications occurred postoperatively. The mean length of hospital stay was 9.1 ± 1.4 (range 7-11) days with a mean follow-up period of 18.7 ± 6.7 (range 8-32) months. One patient had AF recurrence 6 months postoperatively. No pulmonary vein stenosis was detected at the 3rd postoperative month. There were no deaths or thromboembolic events during follow-up. CONCLUSIONS This concomitant therapy proved to be safe and yielded good clinical outcomes. Therefore, it deserves to be considered as a treatment for patients with SPN and NVAF.
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Affiliation(s)
- Rongxin Lu
- Department of Cardiothoracic Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ju Mei
- Department of Cardiothoracic Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Dongfang Zhao
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Zhaolei Jiang
- Department of Cardiothoracic Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Haibo Xiao
- Department of Cardiothoracic Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Mingsong Wang
- Department of Cardiothoracic Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Nan Ma
- Department of Cardiothoracic Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
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13
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Kaaki S, Kidane B, Srinathan S, Tan L, Buduhan G. Is tissue still the issue? Lobectomy for suspicious lung nodules without confirmation of malignancy. J Surg Oncol 2018; 117:977-984. [PMID: 29473958 DOI: 10.1002/jso.25003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/10/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Histologic confirmation of malignancy has been indicated for a suspicious lung nodule prior to resection. The purpose of this study was to determine whether or not foregoing routine tissue biopsy increased the incidence of lobectomy for benign lesions. METHODS Retrospective cohort of 256 patients who underwent thoracoscopic or open lobectomy for a confirmed or suspected pulmonary malignancy, with or without tissue diagnosis. Clinical, radiographic, and pathologic data were compared. RESULTS Among 256 patients, 127 had attempted biopsy (group A) and 129 had no biopsy procedure (group B). There was no significant difference in the incidence of benign resections between the groups (Group A = 4 (3.2%) benign pathology vs group B = 9 (7.0%; P = 0.16). Group B had significantly lower operative time (127.1 vs 112.3 minutes; P = 0.004) and intraoperative complications (23 vs 37 patients; P = 0.03). There was a trend toward longer hospital stay and surgical waiting time in group A (6.6 vs 5.2 days, P = 0.24; 92.4 vs 66.2 days; P = 0.14, respectively). CONCLUSION Foregoing biopsies and proceeding to lobectomy in selected patients with suspicious lung nodules is safe, did not increase the incidence of resected benign pathology, and may decrease surgical wait time. Patients should be carefully evaluated and counseled.
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Affiliation(s)
- Suha Kaaki
- Section of General Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Canada
| | - Biniam Kidane
- Section of Thoracic Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Canada
| | - Sadeesh Srinathan
- Section of Thoracic Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Canada
| | - Lawrence Tan
- Section of Thoracic Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Canada
| | - Gordon Buduhan
- Section of Thoracic Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Canada
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14
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Seijo LM. Electromagnetic navigation bronchoscopy: clinical utility in the diagnosis of lung cancer. LUNG CANCER-TARGETS AND THERAPY 2016; 7:111-118. [PMID: 28210167 PMCID: PMC5310707 DOI: 10.2147/lctt.s98643] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Electromagnetic navigation bronchoscopy (ENB) is one of several technological advances which have broadened the indications for bronchoscopy in the diagnostic workup of lung cancer. The technique facilitates bronchoscopic sampling of peripheral pulmonary nodules as well as mediastinal lymph nodes, although wide availability and expertise in endobronchial ultrasonography has limited its application in routine clinical practice to the former. ENB in this setting is quite versatile and may be considered an established alternative to more invasive techniques, especially in selected patients with underlying pulmonary disease or comorbidities at high risk for complications from computer topography-guided fine needle aspiration or surgical resection. Nodule sampling may be performed with a variety of instruments, including forceps, cytology brushes, and transbronchial needles. Although samples are generally small, they are often suitable for molecular analysis.
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Affiliation(s)
- Luis M Seijo
- Pulmonary Department, Instituto de Investigación Sanitaria-Fundación Jimenez Díaz-Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Madrid, Spain
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15
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Kesler KA. Conventional bronchoscopy for evaluation of the solitary pulmonary nodule: Beneficial for a select few patients, or are we still "looking for a needle in a haystack"? J Thorac Cardiovasc Surg 2015; 150:40-1. [PMID: 25816963 DOI: 10.1016/j.jtcvs.2015.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 02/12/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Kenneth A Kesler
- Thoracic Division, Department of Surgery, Indiana University, Indianapolis, Ind.
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