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Hao M, Fang Z, Ding J, Li C, Wei Y, Zhang W. Effects of preoperative needle biopsy for lung cancer on survival and recurrence: a systematic review and meta-analysis. Surg Today 2024; 54:95-105. [PMID: 36348163 DOI: 10.1007/s00595-022-02617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
Needle biopsy (NB) is used for the diagnosis of lung cancer, but there is still controversy about its effect on the prognosis after surgery. We conducted this meta-analysis to compare the prognosis of lung cancer patients who underwent preoperative NB with that of those who did not. We systematically searched seven databases and Google Scholar for eligible studies. Recurrence-free survival (RFS) and overall survival (OS) were analyzed as primary outcome measures. Nine articles with a collective total of 13,541 patients (NB group, n = 4550; non-NB group, n = 8991) were included in our meta-analysis. OS [hazard ratio (HR) = 1.43 (0.96, 2.12), p = 0.08] and RFS (HR = 1.59 [1.25, 2.01], p = 0.0001) tended to be better in the non-NB group than in the NB group. Pleural recurrence (risk ratio (RR) = 2.40 [1.42, 4.07], p = 0.001) was significantly lower in the non-NB group than in the NB group. The recurrence analysis data did not reach significance, but the overall trend was better for the non-NB group. These findings demonstrate that NB is detrimental to the survival prognosis of lung cancer patients and increases the chance of pleural recurrence.
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Affiliation(s)
- Meiqi Hao
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Zige Fang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Jiatong Ding
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Chenxi Li
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Yiping Wei
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Wenxiong Zhang
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
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Zhang Y, Hu Y, Zhang S, Zhu M, Lu J, Hu B, Guo X, Zhang Y. Effects of pre-operative biopsy on recurrence and survival in stage I lung adenocarcinoma patients in China. ERJ Open Res 2023; 9:00675-2022. [PMID: 37583968 PMCID: PMC10423981 DOI: 10.1183/23120541.00675-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/04/2023] [Indexed: 08/17/2023] Open
Abstract
Background Whether pre-operative biopsy affects post-operative recurrence and metastasis of lung cancer patients is still controversial. Methods In order to clarify these disputes, we collected relevant literature to conduct a meta-analysis. To validate the results of the meta-analysis, we retrospectively analysed 575 patients with stage I lung adenocarcinoma who underwent surgical resection at our centre from 2010 to 2018 using propensity score matching and competing risk models. Results 5509 lung cancer patients from 11 articles were included in the meta-analysis. Summary analysis showed that the total recurrence rate of the biopsy group was higher than that of the nonbiopsy group (risk ratio 1.690, 95% CI 1.220-2.330; p=0.001). After propensity score matching, we found that there was no significant correlation between biopsy and total recurrence (risk ratio 1.070, 95% CI 0.540-2.120; p=0.850). In our cohort, of 575 stage I lung adenocarcinomas, 113 (19.7%) patients underwent pre-operative biopsy. During a median (interquartile range) follow-up of 71 (57-93) months, multivariable analyses showed pre-operative biopsy in the overall observation cohort (subdistribution hazard ratio (SHR) 1.522, 95% CI 0.997-2.320; p=0.051) and in the propensity score-matched cohort (SHR 1.134, 95% CI 0.709-1.810; p=0.600) was not significantly correlated with the risk of recurrence and metastasis. Moreover, the pre-operative biopsy did not affect disease-free survival (SHR 0.853, 95% CI 0.572-1.273; p=0.438) or overall survival (SHR 0.647, 95% CI 0.352-1.189; p=0.161). Conclusion Pre-operative biopsy might not increase the risk of recurrence and metastasis, suggesting that these procedures might be safe for patients with stage I lung adenocarcinoma whose diagnosis is difficult to determine before surgery.
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Affiliation(s)
- Yuan Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
- These authors contributed equally
| | - Yi Hu
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
- These authors contributed equally
| | - Shu Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
| | - Min Zhu
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
| | - Jun Lu
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Bin Hu
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaojuan Guo
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yuhui Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
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Ding Y, Li J, Li X, Xu M, Geng H, Sun D. Impact of preoperative biopsy on tumor spread through air spaces in stage I non-small cell lung cancer: a propensity score-matched study. BMC Pulm Med 2022; 22:293. [PMID: 35907818 PMCID: PMC9339177 DOI: 10.1186/s12890-022-02090-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Percutaneous needle biopsy (PNB) and bronchoscopic biopsy (BB) are widely used in the preoperative diagnosis of pulmonary nodules, but whether PNB or BB may cause tumor spread through air spaces (STAS) has not been reported. Methods 433 postoperative patients with pathological stage I non-small cell lung cancer (NSCLC) from January 2015 to December 2018 at our hospital were enrolled and divided into PNB group (n = 40), BB group (n = 48) and non-biopsy group (n = 345). The PNB and BB groups were matched using propensity score matched (PSM) separately from the non-biopsy group, after which the effects of PNB and BB on STAS, recurrence-free survival (RFS) and overall survival (OS) were assessed. Results After PSM for 9 confounding factors (gender, age, smoking history, tumor site, scope of surgery, pathology type, stage, maximum tumor diameter and postoperative treatment), 38 cases in the PNB group were successfully matched with 38 cases in the non-biopsy group and 28 cases in the BB group were successfully matched with 28 cases in the non-biopsy group. After PSM, there was no significant difference in the incidence of STAS between the PNB and non-biopsy groups (42.1% vs. 34.2%, P > 0.05) and between the BB and non-biopsy groups (42.9% vs. 46.4%, P > 0.05). The results after PSM showed no significant effect of both PNB and BB on RFS and OS after radical surgery (P > 0.05). Conclusion Preoperative biopsy in patients with stage I NSCLC has not been shown to increase the occurrence of STAS, nor postoperative recurrence and death.
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Affiliation(s)
- Yun Ding
- Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
| | - Jiuzhen Li
- Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
| | - Xin Li
- Clinical School of Thoracic, Tianjin Medical University, Tianjin, China.,Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, China
| | - Meilin Xu
- Clinical School of Thoracic, Tianjin Medical University, Tianjin, China.,Department of Pathology, Tianjin Chest Hospital, Tianjin, China
| | - Hua Geng
- Clinical School of Thoracic, Tianjin Medical University, Tianjin, China.,Department of Pathology, Tianjin Chest Hospital, Tianjin, China
| | - Daqiang Sun
- Clinical School of Thoracic, Tianjin Medical University, Tianjin, China. .,Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, China.
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Kim DH, Bae SY, Na KJ, Park S, Park IK, Kang CH, Kim YT. Radiological and clinical features of screening-detected pulmonary invasive mucinous adenocarcinoma. Interact Cardiovasc Thorac Surg 2021; 34:229-235. [PMID: 34570199 PMCID: PMC8766211 DOI: 10.1093/icvts/ivab257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/08/2021] [Accepted: 08/14/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The current understanding of pulmonary invasive mucinous adenocarcinoma is largely based on studies of advanced stage patients and data about early-stage invasive mucinous adenocarcinoma are sparse. We evaluated the radiological and clinical features of screening-detected early-stage invasive mucinous adenocarcinoma (SD-IMA). METHODS Data from 91 patients who underwent surgical treatment for SD-IMA (≤3 cm) from 2013 to 2019 were reviewed retrospectively. Data on radiological characteristics, clinicopathological findings, recurrence and survival were obtained. Disease-free survival rate was analysed. RESULTS Radiologically, SD-IMAs presented as a pure ground-glass nodule (6.6%), part-solid nodule (38.5%) or solid (54.9%). Dominant locations were both lower lobes (74.7%) and peripheral area (93.4%). The sensitivity of percutaneous needle biopsy was 78.1% (25/32). Lobectomy was performed in 70 (76.9%) patients, and sublobar resection in 21 (23.1%) patients. Seventy-three (80.2%), 15 (16.5%) and 3 (3.3%) patients had pathological stage IA, IB and IIB or above, respectively. Seven patients developed recurrence, and 3 died due to disease progression. Pleural seeding developed exclusively in 2 patients who underwent needle biopsy. The 5-year disease-free survival rate was 89.4%. The disease-free survival rates at 5 years were 86.3% in the lobectomy group and 100% in the sublobar resection group. CONCLUSIONS SD-IMAs were mostly radiologically invasive nodules. SD-IMAs showed favourable prognosis after surgical treatment.
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Affiliation(s)
- Dae Hyeon Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea
| | - So Young Bae
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Kwon Joong Na
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Samina Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - In Kyu Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Chang Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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Zhao L, Yang W, Hong R, Fei J. Application of three-dimensional reconstruction combined with dial positioning in small pulmonary nodules surgery. J Cardiothorac Surg 2021; 16:254. [PMID: 34496890 PMCID: PMC8424933 DOI: 10.1186/s13019-021-01642-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background With the popularization of HRCT and VATS, the incidence of early stage lung cancer is increasing recent years. About 63% of small pulmonary nodules can not be accurately identified in VATS. We use 3-D reconstruction combined with dial positioning to analyze its accuracy and impact on patients undergoing VATS in our hospital.
Method All patients underwent HRCT scanning and 3-D reconstruction preoperatively to determine the scope of surgery. The precise positional relationship between the nodule and the nearest rib must be recorded. Locate the plane of pulmonary nodule on CT, rotate the plane to make the affected side upwards, take the highest point of pleura as 12 o'clock on the dial, record the corresponding point of the nodule meticulously, mark the pulmonary nodule on the skin of the patient. A 18G indwelling needle was used to puncture through the marker into the visceral pleura. Electrocautery mark was made on the bleeding point of the lung surface. Then wedge resection or segmental resection was made. Materials and result From September 2019 to December 2020, 74 patients underwent VATS pulmonary nodule resection in our institute, with an average age of (56.4 ± 11.7) years old. A total of 83 nodules were resected in 74 patients, 23 nodules received segmentectomy and 60 nodules received wedge resection with 16 benign nodules and 67 malignant nodules. The distance between the nodules and pleura was (0–25) mm, with an average of (8.0 ± 3.9) mm. The target nodules were found in all patients, the positioning accuracy was 97.6%. All patients were satisfied with the positioning method, and there was no scar left at the skin puncture point after operation. Conclusion 3-D reconstruction combined with dial positioning method can reduce patients' anxiety preoperatively, avoid various complications, reduce hospitalization expenses, and has an acceptable accuracy and short learning curve, which can be further promoted and applied in clinic.
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Affiliation(s)
- Long Zhao
- Cardiovascular Surgery Department, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo City, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo City, China
| | - Wenyu Yang
- Cardiovascular Surgery Department, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo City, China. .,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo City, China.
| | - Ruofeng Hong
- Cardiovascular Surgery Department, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo City, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo City, China
| | - Jianbin Fei
- Cardiovascular Surgery Department, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo City, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo City, China
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He C, Yu H, Li C, Zhang X, Huang Z, Liu M, Tong L, Zhu J, Wu W, Huang X. Recurrence and disease-free survival outcomes after computed tomography-guided needle biopsy in stage IA non-small cell lung cancer patients in China: a propensity score matching analysis. Quant Imaging Med Surg 2021; 11:3472-3480. [PMID: 34341724 DOI: 10.21037/qims-20-931] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/02/2021] [Indexed: 11/06/2022]
Abstract
Background Whether preoperative biopsy before radical resection can lead to recurrence and impact patient survival in non-small cell lung cancer (NSCLC) remains controversial. In this study, we carried out a retrospective analysis to determine whether preoperative biopsy can cause disease recurrence and influence disease-free survival (DFS) in patients with stage IA NSCLC. Methods Patients diagnosed with stage IA NSCLC (solid nodule) between January 2010 and December 2014 were identified from the databases of 7 Chinese medical centers and divided into two groups: a preoperative computed tomography (CT)-guided needle biopsy (CTNB) plus radical resection group, and a non-CTNB group. The propensity score matching (PSM) method was adopted to balance the observed covariates, and Kaplan-Meier estimates were used for survival analysis. Cox regression was used in a single-factor analysis to identify the factors affecting DFS in stage IA NSCLC. Results After initial screening, 730 patients were enrolled in this study, with 186 and 544 patients in the CTNB group and the non-CTNB group, respectively. After PSM, 186 patients were eventually included in each group. No significant differences in basic clinical features were identified between the two groups (P>0.05). The rates of recurrence were 17.2% and 14.0% in the CTNB and non-CTNB groups (χ2=0.735, P=0.391), respectively. No notable differences in DFS (χ2=1.895, P=0.173) or overall survival (OS, χ2=1.785, P=0.182) were observed. Lung adenocarcinoma [hazard ratio (HR), 0.167, P=0.001] and lesion size (>2 cm) (HR, 2.712, P=0.000) were identified as risk factors for DFS in stage IA NSCLC. Conclusions CTNB does not increase the incidence of recurrence in stage IA NSCLC or affect patient survival; therefore, it is not a risk factor for DFS. Lung adenocarcinoma and lesion size are risk factors for DFS.
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Affiliation(s)
- Chuang He
- Treatment Center of Minimally Invasive Intervention and Radioactive Particles, First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Hualong Yu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Changyi Li
- Department of Respiratory, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Zhang
- Department of Thoracic Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Zhicheng Huang
- Department of Radiology, Jilin Provincial Cancer Hospital, Changchun, China
| | - Mingyang Liu
- Department of Oncology, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Lunbing Tong
- Department of Radiology, Sichuan Police Force Hospital, Leshan, China
| | - Jun Zhu
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Wei Wu
- Department of Thoracic Surgery, First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Xuequan Huang
- Treatment Center of Minimally Invasive Intervention and Radioactive Particles, First Affiliated Hospital of the Army Medical University, Chongqing, China
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Hong H, Hahn S, Matsuguma H, Inoue M, Shintani Y, Honda O, Izumi Y, Asakura K, Asamura H, Isaka T, Lee K, Choi YS, Kim YT, Park CM, Goo JM, Yoon SH. Pleural recurrence after transthoracic needle lung biopsy in stage I lung cancer: a systematic review and individual patient-level meta-analysis. Thorax 2021; 76:582-590. [PMID: 33723018 DOI: 10.1136/thoraxjnl-2020-216492] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Conflicting results exist regarding whether preoperative transthoracic biopsy increases the risk of pleural recurrence in early lung cancer. We conducted a systematic, patient-level meta-analysis to evaluate the risk of pleural recurrence in stage I lung cancer after percutaneous transthoracic lung biopsy. METHODS A systematic search of OVID-MEDLINE, Embase and the Cochrane Database of Systematic Reviews was performed through October 2018. Eligible studies were original articles on the risk of pleural recurrence in stage I lung cancer after transthoracic biopsy. We contacted the corresponding authors of eligible studies to obtain individual patient-level data. We used the Fine-Gray model for time to recurrence and lung cancer-specific survival and a Cox proportional hazards model for overall survival. RESULTS We analysed 2394 individual patient data from 6 out of 10 eligible studies. Compared with other diagnostic procedures, transthoracic biopsy was associated with a higher risk for ipsilateral pleural recurrence, which manifested solely (subdistribution HR (sHR), 2.58; 95% CI 1.15 to 5.78) and concomitantly with other metastases (sHR 1.99; 95% CI 1.14 to 3.48). In the analysis of secondary outcomes considering a significant interaction between diagnostic procedures and age groups, reductions of time to recurrence (sHR, 2.01; 95% CI 1.11 to 3.64), lung cancer-specific survival (sHR 2.53; 95% CI 1.06 to 6.05) and overall survival (HR 2.08; 95% CI 1.12 to 3.87) were observed in patients younger than 55 years, whereas such associations were not observed in other age groups. DISCUSSION Preoperative transthoracic lung biopsy was associated with increased pleural recurrence in stage I lung cancer and reduced survival in patients younger than 55 years.
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Affiliation(s)
- Hyunsook Hong
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seokyung Hahn
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Haruhisa Matsuguma
- Divisions of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan
| | - Masayoshi Inoue
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
| | - Osamu Honda
- Department of Radiology, Kansai Medical University, Moriguchi, Osaka, Japan
| | - Yotaro Izumi
- Department of General Thoracic Surgery, Saitama Medical University, Saitama Medical Center, Kawagoe, Saitama, Japan
| | - Keisuke Asakura
- Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Hisao Asamura
- Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Tetsuya Isaka
- Department of Respiratory Surgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Kyungjong Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Soo Choi
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Huang CS, Chien HC, Chen CK, Yeh YC, Hsu PK, Chen HS, Hsieh CC, Hsu HS, Huang BS, Shih CC. Significance of preoperative biopsy in radiological solid-dominant clinical stage I non-small-cell lung cancer. Interact Cardiovasc Thorac Surg 2020; 32:537-545. [PMID: 33332546 DOI: 10.1093/icvts/ivaa297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/21/2020] [Accepted: 10/27/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The present study aimed to clarify the association between preoperative biopsy and surgical outcomes in clinical stage I non-small-cell lung cancer (NSCLC) with different proportions of ground-glass opacity (GGO). METHODS Data on patients who underwent pulmonary resection for NSCLC from 2006 to 2016 were drawn from a prospective registered database and analysed retrospectively. Patient characteristics collected included tumour size, location and staging, surgical approach, consolidation-tumour ratio, histopathology and the presence or absence of preoperative biopsy to identify the independent prognostic factors of disease-free survival (DFS) and cancer-specific survival. A 1:1 propensity score matching was conducted between the preoperative biopsy and reference groups based on their baseline characteristics measured before the decision for preoperative biopsy. RESULTS A total of 1427 patients were collected to achieve an overall 5-year DFS as 84.5% (median follow-up: 67.3 months), stratified to be 99.5% in the GGO-dominant group (n = 430) and 78.2% in the solid-dominant group (n = 997). Only 2 patients (0.5%) in the GGO-dominant group experienced tumour recurrence. For solid-dominant tumours matched with propensity scores (279 in preoperative biopsy vs 279 in reference group), the independent predictors of DFS included preoperative biopsy, sublobar resection, pathological staging and angiolymphatic invasion. Preoperative biopsy was a predictor of cancer-specific survival in univariable analysis but was not in multivariable analysis. Significant differences were also found between matched groups in those with late-delay surgery, but not in patients receiving preoperative biopsy with early-delay surgery (≤21 days). CONCLUSION Preoperative biopsy may worsen surgical outcomes in patients with clinical stage I, solid-dominant NSCLC.
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Affiliation(s)
- Chien-Sheng Huang
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hung-Che Chien
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Ku Chen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Chen Yeh
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Kuei Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Shan Chen
- Department of Health Care Administration, Chang Jung Christian University, Tainan City, Taiwan
| | - Chih-Cheng Hsieh
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Han-Shui Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Biing-Shiun Huang
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Che Shih
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
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Li H, Chen R, Zhao J. Correlation between percutaneous transthoracic needle biopsy and recurrence in stage I lung cancer: a systematic review and meta-analysis. BMC Pulm Med 2020; 20:198. [PMID: 32689974 PMCID: PMC7372860 DOI: 10.1186/s12890-020-01235-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To systematically evaluate the correlation between percutaneous transthoracic needle biopsy (PTNB) and recurrence in stage I lung cancer. METHODS The databases of PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and China Biology Medicine disc were retrieved to collect relevant literatures about the correlation between PTNB and recurrence in stage I lung cancer. The retrieval time was limited from the time of their database establishment to April 30/2020.Screened the literature, extracted the data and assessed the quality of studies included. Then the meta-analysis was performed by using Stata l6.0 software. RESULTS A total of 8 cohort studies involving 2760 lung cancer patients were included. The results of meta-analysis showed that PTNB did not increase the risk of total recurrence and pleural recurrence in the patients with stage I lung cancer. The result of subgroup analysis is according to the tumor location. For stage I lung cancer, PTNB will increase the risk of pleural recurrence in patients with sub-pleural lesions but not in those without sub-pleural lesions. CONCLUSIONS To stage I lung cancer, PTNB is not associated with the total recurrence and pleural recurrence but PTNB will increase the risk of pleural recurrence in patients with sub-pleural lesions.
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Affiliation(s)
- Haichao Li
- Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Rong Chen
- Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Jian Zhao
- Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
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Toyoda T, Suzuki H, Hata A, Yamamoto T, Morimoto J, Sakairi Y, Wada H, Nakajima T, Yoshino I. Is needle biopsy a risk factor of pleural recurrence after surgery for non-small cell lung cancer? J Thorac Dis 2020; 12:2635-2643. [PMID: 32642171 PMCID: PMC7330316 DOI: 10.21037/jtd.2020.03.16] [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: 11/28/2022]
Abstract
Background Tumor seeding, whereby malignant cells are deposited along the needle tract, is considered to be a potential hazard of needle biopsies. The aim of this study is to elucidate the relationship between needle biopsies for lung tumor, such as a preoperative computed tomography-guided needle biopsy (PCTGNB) or an intraoperative fine-needle aspiration biopsy (IFNAB), and ipsilateral pleural recurrence (PR) after lung cancer surgery. Methods Between 2008 and 2017, 1,047 patients with non-small cell lung cancer (NSCLC) underwent curative lung resection in our institution. They were divided into two groups: those in whom the first recurrent site was the ipsilateral pleural cavity (PR group) and the others (control group). Risk factors of PR were investigated retrospectively. Results Recurrence was observed in 191 patients (18.2%), 25 of whom were categorized to the PR group (17 malignant effusion, 10 dissemination). Pathological tumor [2–4], lymph nodes [1–2], pleural, lymphatic and vascular invasion (each ≥1) factors and patients who underwent PCTGNB were more frequently observed in the PR group than in the control group (each P<0.01) whereas the proportion of patients who underwent IFNAB was not significant. A multivariate analysis identified pathological lymph node factor and the frequency of PCTGNB as independent risk factors for PR with hazard ratios of 7.33 (95% CI, 2.93–19.8; P<0.01) and 6.92 (95% CI, 2.25–17.8; P<0.01), respectively. Conclusions PCTGNB is a risk factor of PR but IFNAB is not. Indications for PCTGNB should be carefully determined.
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Affiliation(s)
- Takahide Toyoda
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidemi Suzuki
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Hata
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takayoshi Yamamoto
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Junichi Morimoto
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yuichi Sakairi
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hironobu Wada
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takahiro Nakajima
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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11
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Cheng D, Wang Z, Cui J, Liu L. Does percutaneous transthoracic needle biopsy increase the risk of pleural recurrence in patients with stage I lung cancer? Interact Cardiovasc Thorac Surg 2020; 30:834-838. [PMID: 32390049 DOI: 10.1093/icvts/ivaa027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 12/15/2019] [Accepted: 02/02/2020] [Indexed: 02/05/2023] Open
Abstract
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: does percutaneous transthoracic needle biopsy (PTNB) increase the risk of pleural recurrence in patients with stage I lung cancer? Altogether, 298 papers were found using the reported search, of which 7 cohort studies and 1 meta-analysis represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Four cohort studies suggested an association between PTNB and pleural recurrence in patients with stage I lung cancer, while the other 3 cohort studies found that PTNB had no impact. One meta-analysis (the largest study) including 5 of the cohort studies above concluded that PTNB increased the risk of pleural recurrence among patients with stage I lung cancer with subpleural lesions. Based on the available evidence, it was suggested that there may be an association between PTNB and pleural recurrence in patients with stage I lung cancer, especially for patients with subpleural lesion.
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Affiliation(s)
- Diou Cheng
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zihuai Wang
- West China School of Medicine, Sichuan University, Chengdu, China.,Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Cui
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Lunxu Liu
- West China School of Medicine, Sichuan University, Chengdu, China.,Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
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12
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Kato A, Yasuo M, Tokoro Y, Kobayashi T, Ichiyama T, Tateishi K, Ushiki A, Urushihata K, Yamamoto H, Hanaoka M. Virtual bronchoscopic navigation as an aid to CT-guided transbronchial biopsy improves the diagnostic yield for small peripheral pulmonary lesions. Respirology 2018; 23:1049-1054. [PMID: 30084517 DOI: 10.1111/resp.13377] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 04/17/2018] [Accepted: 04/30/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Virtual bronchoscopic navigation (VBN) entails the provision of a virtual display of the bronchial routes that lead to small peripheral pulmonary lesions (PPL). It has been predicted that a combination of computed tomography (CT)-guided transbronchial biopsy (CT-TBB) with VBN might improve the diagnostic yield for small PPL. This study sought to investigate that prediction. METHODS A total of 100 patients with small PPL (<20 mm) were enrolled for CT-TBB and randomly allocated to either a VBN+ or VBN- group (50 subjects per group). Group results were then compared in terms of diagnostic yield, whole procedure time, times at which the first CT scan and biopsy were taken and the number of lung biopsy specimens retrieved. RESULTS The diagnostic yield for small PPL was significantly higher in the VBN+ group versus VBN- group (84% vs 58%, respectively (P = 0.013)), with no significant difference in (whole) examination time between groups (VBN+: 32:53 (32 min and 53 s) ± 12:01 vs VBN-: 33:06 ± 10:08 (P = NS)). However, the time periods between commencing the examination and either the first CT scan or first biopsy were significantly shorter for the VBN+ group, while the net biopsy time tended to be longer for this group with a significantly higher number of specimens collected (VBN+: 3.54 ± 1.07 specimens vs VBN-: 2.98 ± 1.06 specimens (P = 0.01)). CONCLUSION Combining VBN with CT-TBB significantly improved the diagnostic yield for small PPL.
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Affiliation(s)
- Akane Kato
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masanori Yasuo
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yayoi Tokoro
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Kobayashi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Ichiyama
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazunari Tateishi
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Atsuhito Ushiki
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazuhisa Urushihata
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Yamamoto
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masayuki Hanaoka
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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13
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Hu C, Jiang J, Li Y, Zhang C, Zhang W, Jiang H, Gao Y, Zhuang W, Lei K, Tang Y, Wan R. Recurrence risk after preoperative biopsy in patients with resected early-stage non-small-cell lung cancer: a retrospective study. Cancer Manag Res 2018; 10:1927-1934. [PMID: 30013399 PMCID: PMC6038855 DOI: 10.2147/cmar.s166930] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Tumor cell dissemination after needle biopsy has been reported in a variety of malignancies, including non-small-cell lung cancer (NSCLC). However, there is little clinical evidence in regard to whether preoperative biopsy increases the risk of recurrence in completely resected NSCLC. Patients and methods A total of 322 patients diagnosed as pathological stage I NSCLC using intraoperative biopsy (IOB) (control group), preoperative percutaneous needle biopsy (PNB) or bronchoscopic biopsy were included in this study. Baseline characteristics were collected and compared. The disease-free survival (DFS) of patients was analyzed using Kaplan–Meier method. Subgroup analysis and Cox regression were performed to evaluate the effect of preoperative biopsy on recurrence risk with adjustment for potential confounders. Results Among these patients, 202 (63%) underwent IOB, 66 (20%) underwent PNB, and 54 (17%) underwent bronchoscopic biopsy. DFS of patients who had preoperative PNB or bronchoscopic biopsy was similar to those who had IOB (P=0.514 and 0.869). Neither preoperative PNB nor transbronchial biopsy significantly affected recurrence incidence across all the relevant subgroups. Furthermore, multivariate analysis showed that preoperative biopsy was not associated with increased recurrence risk in NSCLC patients with adjustment for confounders, while squamous cell carcinoma and adjuvant chemotherapy were associated with prolonged DFS. Conclusion Neither preoperative PNB nor bronchoscopic biopsy increased the recurrence risk in patients with resected stage I NSCLC, indicating that these procedures could be safely used for diagnosis of early-stage NSCLC.
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Affiliation(s)
- Chengping Hu
- Department of Respiratory and Critical Care Medicine, National Key Clinical Specialty, Xiangya Hospital, Central South University, Changsha, China,
| | - Juan Jiang
- Department of Respiratory and Critical Care Medicine, National Key Clinical Specialty, Xiangya Hospital, Central South University, Changsha, China,
| | - Yuanyuan Li
- Department of Respiratory and Critical Care Medicine, National Key Clinical Specialty, Xiangya Hospital, Central South University, Changsha, China,
| | - Chunfang Zhang
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Weixing Zhang
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Haihe Jiang
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Gao
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Wei Zhuang
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Kaibo Lei
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yong Tang
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Rongjun Wan
- Department of Respiratory and Critical Care Medicine, National Key Clinical Specialty, Xiangya Hospital, Central South University, Changsha, China,
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14
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Risk of pleural recurrence after percutaneous transthoracic needle biopsy in stage I non-small-cell lung cancer. Eur Radiol 2018; 29:270-278. [DOI: 10.1007/s00330-018-5561-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/04/2018] [Accepted: 05/23/2018] [Indexed: 12/26/2022]
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15
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Xi Y, Fan J, Che D, Zhai K, Ren T, Feng X, Shang L, Hu J, Yu Y, Meng Q. Distant Metastasis and Survival Outcomes after Computed Tomography-Guided Needle Biopsy in Resected Stage I-III Non-Small Cell Lung Cancer. J Cancer 2017; 8:3356-3361. [PMID: 29158808 PMCID: PMC5665052 DOI: 10.7150/jca.20784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022] Open
Abstract
Background and objective Several reports describe the needle-tract implantation after percutaneous needle lung biopsy. The present study evaluated whether preoperative computed tomography-guided needle biopsy (CTNB) affected the distant metastasis and overall survival in patients with early non-small cell lung cancer (NSCLC). Methods A total of 1667 patients with pathological stage I-III NSCLC were assimilated. Of these, 168 patients received preoperative CTNB, whereas 1499 patients were not subjected to any biopsy before surgical resection. Propensity score matching method was adopted to balance the observed covariates between the two groups. Cox regression analysis and Kaplan-Meier estimations were used for survival analysis. Subset analysis was performed in the p-stage ≤ II cases. Results The distant metastasis and mortality were not significantly increased for all patients with preoperative CTNB (P = 0.142 and P = 0.125, respectively). The subset analysis of p-stage ≤ II cases showed that CTNB increased the risk of distant metastasis (P = 0.032) while not increasing the risk of mortality (P = 0.086). Conclusion CTNB can increase the risk of distant metastasis in the p-stage ≤ II patients.
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Affiliation(s)
- Yuhui Xi
- The pathophysiology department of Harbin Medical University, Harbin, China, 150081
| | - Jingli Fan
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Dehai Che
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Keke Zhai
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Tingting Ren
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Xiao Feng
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Lihua Shang
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Jing Hu
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Yan Yu
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
| | - Qingwei Meng
- Medical oncology department of Harbin Medical University Cancer Hospital, Harbin, China, 150040
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16
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Ipsilateral pleural recurrence after diagnostic transthoracic needle biopsy in pathological stage I lung cancer patients who underwent curative resection. Lung Cancer 2017; 111:69-74. [PMID: 28838402 DOI: 10.1016/j.lungcan.2017.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/04/2017] [Accepted: 07/07/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The relationship between transthoracic needle biopsy (TTNB) and pleural recurrence of cancer after curative lung resection remains unclear. We aimed to assess whether TTNB increases the ipsilateral pleural recurrence (IPR) rate and identify other potential risk factors for pleural recurrence after surgery. MATERIALS AND METHODS This retrospective study included 392 patients with p-stage I non-small cell lung cancer with solid or part-solid nodules after curative lung resection in 2009-2010. Imbalances among the characteristics were adjusted using an inverse probability-weighted method based on propensity scoring. Multivariate Cox's regression analysis and the Kaplan-Meier method were used to determine independent risk factors for IPR. RESULTS A total of 243 (62%) patients received TTNB, while 149 (38%) underwent an alternate, or no, diagnostic technique. IPR was significantly more frequent in the TTNB group (p=0.004), while total recurrence was similar between the groups (p=0.098). After applying the weighted model, diagnostic TTNB (hazard ratio [HR], 5.27; 95% confidence interval [CI], 1.49-18.69; p=0.010), microscopic visceral pleural invasion (HR, 2.76; 95% CI, 1.08-7.01; p=0.033) and microscopic lymphatic invasion (HR, 3.25; 95% CI, 1.30-8.10; p=0.012) were associated with an increased frequency of IPR. Among patients who received TTNB, microscopic lymphatic invasion was a risk factor for IPR (HR, 2.74; 95% CI, 1.10-6.79; p=0.030). CONCLUSIONS The diagnostic TTNB procedure is associated with pleural recurrence but may be unrelated to overall recurrence-free survival in early lung cancer. Moreover, microscopic lymphatic invasion could be a risk factor for pleural recurrence. TTNB should be carefully considered before lung resection and close follow-up to detect if pleural recurrence is needed.
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17
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Fan J, Zhai K, Ren T, Feng X, Sui L, Hu J, Meng Q. [Distant Metastasis and Survival Outcomes after Computed Tomography-guided Needle Biopsy in Stage I-II Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2017; 20:187-191. [PMID: 28302221 PMCID: PMC5973298 DOI: 10.3779/j.issn.1009-3419.2017.03.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Computed tomography-guided needle biopsy (CTNB) is a well-established and commonly used technique for diagnosing pulmonary nodules with high accuracy and safety. Needle-tract implantation after CTNB has been reported in various reports. The aim of this study is to evaluate whether preoperative CTNB affected the distant metastasis and overall survival in pathological stage I-II lung cancer patients. METHODS A total of 1,234 patients with pathological stage I-II non-small cell lung cancer were collected. 113 patients received preoperative CTNB, and 1,121 patients did not receive any biopsy before surgical resection. Propensity score-matching method was adopted to balance observed covariates between two groups, 113 pairs were matched. Cox regression analysis and Kaplan-Meier estimates were used to process survival analysis. RESULTS Distant metastasis free survival (DMFS) was significantly poorer in the preoperative CTNB group than in the non-biopsy group (P=0.032). But there was no difference in the overall survival between the two groups (P=0.086). CONCLUSIONS CTNB increased the risk of distant metastasis, not increasing the risk of mortality.
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Affiliation(s)
- Jingli Fan
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150000, China
| | - Keke Zhai
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150000, China
| | - Tingting Ren
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150000, China
| | - Xiao Feng
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150000, China
| | - Lin Sui
- Department of Medical Imaging, Harbin Medical University Cancer Hospital, Harbin 150000, China
| | - Jing Hu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150000, China
| | - Qingwei Meng
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150000, China
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Risk of Pleural Recurrence in Early Stage Lung Cancer Patients after Percutaneous Transthoracic Needle Biopsy: A Meta-analysis. Sci Rep 2017; 7:42762. [PMID: 28202941 PMCID: PMC5311878 DOI: 10.1038/srep42762] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/13/2017] [Indexed: 02/05/2023] Open
Abstract
Percutaneous transthoracic needle biopsies (PTNB) are widely used for the diagnosis of a peripheral pulmonary nodules, but the risk of pleural recurrence in lung cancer patients remains undetermined. Our meta-analysis aims to answer the question whether PTNB strategy increases the risk of recurrence. PubMed, EMBASE, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched from inception to January 9, 2016. A total of 1242 patients from 5 studies were included. The results showed that PTNB does not increase risk of total recurrence (Odds Ratio,0.78; 95% CI, 0.53 to 1.15) or pleural recurrence (Odds Ratio,1.58; 95% CI, 0.41 to 6.12) compared with non-PTNB strategies in early stage lung cancer patients. Subgroup analysis showed that PTNB was associated with increased pleural recurrence (Odds Ratio, 10.76; 95% CI, 2.92 to 39.70) in patients with sub-pleural lesions but not in patients without sub-pleural lesions (Odds Ratio, 0.96; 95% CI, 0.24 to 3.89). In conclusion, PTNB should not be recommended in lung cancer patients with sub-pleural lesions. However, PTNB is recommendable to use in other patients without sub-pleural lesions to whom pathological diagnosis is necessary, especially in patients with relevant comorbidities.
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