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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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Impact of Preoperative Diagnostic Biopsy Procedure on Spread Through Airspaces and Related Outcomes in Resected Stage I Non-Small Cell Lung Cancer. Chest 2022; 162:1199-1212. [DOI: 10.1016/j.chest.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 12/25/2022] Open
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Yasukawa M, Kawaguchi T, Kimura M, Tojo T, Taniguchi S. Implications of Preoperative Transbronchial Lung Biopsy for Non-small Cell Lung Cancer Less than 3-cm. In Vivo 2021; 35:1027-1031. [PMID: 33622898 DOI: 10.21873/invivo.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Transbronchial lung biopsy (TBLB) has been recommended for patients with suspected lung cancer. However, its diagnostic value is limited to small lesions, and some studies have indicated that biopsy might be related to metastasis and/or dissemination. This study aimed to evaluate the outcomes after preoperative TBLB for non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS Data were reviewed from 371 patients with resected pN0 NSCLC less than 3-cm. Patients were divided into two groups: TBLB and Non-TBLB. Recurrence-free survival (RFS) curves were plotted using the Kaplan-Meier method. Cox regression analyses were used to evaluate the hazard ratio (HR) with the endpoint RFS. RESULTS The 5-year RFS rates were 75.5% in the TBLB group and 91.4% in the Non-TBLB group (p<0.001). Poor RFS was independently associated with TBLB (HR=2.491, 95%CI=1.337-4.640; p=0.004). CONCLUSION Preoperative TBLB may adversely affect RFS among NSCLC patients with small size tumours.
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Affiliation(s)
- Motoaki Yasukawa
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan; .,Department of Surgery, Osaka Kaisei Hospital, Osaka, Japan
| | - Takeshi Kawaguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Michitaka Kimura
- Department of Thoracic Surgery, Saiseikai Chuwa Hospital, Nara, Japan
| | - Takashi Tojo
- Department of Thoracic Surgery, Saiseikai Chuwa Hospital, Nara, Japan
| | - Shigeki Taniguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
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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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Ijsseldijk MA, Shoni M, Siegert C, Wiering B, van Engelenburg AKC, Tsai TC, Ten Broek RPG, Lebenthal A. Oncologic Outcomes of Surgery Versus SBRT for Non-Small-Cell Lung Carcinoma: A Systematic Review and Meta-analysis. Clin Lung Cancer 2020; 22:e235-e292. [PMID: 32912754 DOI: 10.1016/j.cllc.2020.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/21/2020] [Accepted: 04/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The optimal treatment of stage I non-small-cell lung carcinoma is subject to debate. The aim of this study was to compare overall survival and oncologic outcomes of lobar resection (LR), sublobar resection (SR), and stereotactic body radiotherapy (SBRT). METHODS A systematic review and meta-analysis of oncologic outcomes of propensity matched comparative and noncomparative cohort studies was performed. Outcomes of interest were overall survival and disease-free survival. The inverse variance method and the random-effects method for meta-analysis were utilized to assess the pooled estimates. RESULTS A total of 100 studies with patients treated for clinical stage I non-small-cell lung carcinoma were included. Long-term overall and disease-free survival after LR was superior over SBRT in all comparisons, and for most comparisons, SR was superior to SBRT. Noncomparative studies showed superior long-term overall and disease-free survival for both LR and SR over SBRT. Although the papers were heterogeneous and of low quality, results remained essentially the same throughout a large number of stratifications and sensitivity analyses. CONCLUSION Results of this systematic review and meta-analysis showed that LR has superior outcomes compared to SBRT for cI non-small-cell lung carcinoma. New trials are underway evaluating long-term results of SBRT in potentially operable patients.
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Affiliation(s)
- Michiel A Ijsseldijk
- Division of Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands; Division of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Melina Shoni
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Charles Siegert
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Thoracic Surgery, West Roxbury Veterans Administration, West Roxbury, MA
| | - Bastiaan Wiering
- Division of Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands
| | | | - Thomas C Tsai
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Richard P G Ten Broek
- Division of Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands; Division of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Abraham Lebenthal
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Thoracic Surgery, West Roxbury Veterans Administration, West Roxbury, MA; Harvard Medical School, Boston, MA
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Taniguchi Y, Fukumoto K, Matsui H, Saito T, Murakawa T. Preoperative biopsy does not affect postoperative outcomes of resectable non-small cell lung cancer. Gen Thorac Cardiovasc Surg 2019; 67:615-623. [DOI: 10.1007/s11748-019-01062-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 01/02/2019] [Indexed: 01/13/2023]
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7
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Yasukawa M, Sawabata N, Kawaguchi T, Kawai N, Taniguchi S. Clinical Implications of Transbronchial Biopsy for Surgically-resected Non-small Cell Lung Cancer. ACTA ACUST UNITED AC 2018; 32:691-698. [PMID: 29695580 DOI: 10.21873/invivo.11295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND/AIM Lung biopsies might cause metastasis and/or dissemination. The aim of this study was to review our institutional experience and analyze the outcomes of resection for non-small cell lung cancer (NSCLC), in patients who had received preoperative transbronchial biopsy using fiberoptic bronchoscopy with fluoroscopic imaging (BFS). PATIENTS AND METHODS The medical records of consecutive patients between 2010 and 2015 were retrospectively reviewed. Patients were divided into two groups (BFS and Non-BFS). Overall survival (OS) curves and recurrence-free survival (RFS) curves were plotted using the Kaplan-Meier method. Cox regression analyses were used to evaluate the hazard ratio (HR) with the endpoint OS or RFS. RESULTS We studied the medical records of 531 patients. The 5-year OS rate was 91.8% and 79.8%, in the BFS group and in the Non-BFS group, respectively (p<0.001). BFS was an independent factor associated with RFS HR=2.164 (95%CI=1.399-2.346). CONCLUSION Preoperative BFS is a prognostic factor in patients receiving surgery for NSCLC.
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Affiliation(s)
- Motoaki Yasukawa
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Noriyoshi Sawabata
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Takeshi Kawaguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Norikazu Kawai
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Shigeki Taniguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
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8
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Preoperative bronchoscopic cancer confirmation does not increase risk of recurrence in stage1A non-small cell lung cancer. Gen Thorac Cardiovasc Surg 2018; 66:284-290. [PMID: 29564776 DOI: 10.1007/s11748-018-0909-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 03/17/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study was conducted to evaluate the risk of recurrence possibly caused by preoperative bronchoscopic cancer confirmation in stage1A non-small cell lung cancer. METHODS One hundred and seventy-nine cases of peripheral non-small cell lung cancer (including 151 adenocarcinoma) with no more than 3 cm in their tumor longer diameter were selected. All patients underwent preoperative diagnostic bronchoscopy followed by lobectomy, and were demonstrated to have pathologically free of lymph node involvement and pleural involvement. Radiological and pathological low-grade adenocarcinomas were excluded. Of 179 cases, 95 were confirmed lung cancer by bronchoscope (Group 1) and rest 84 had failed cancer confirmation by bronchoscope before surgery (Group 2). Forty-eight pairs for non-small cell lung cancer and 41 pairs for adenocarcinoma were identified from each group by propensity caliper matching. Kaplan-Meier method and log-rank test were performed on matched groups, and Cox proportional hazard model analysis was performed on whole matched cases. RESULTS Log-rank test revealed no significant inferiority of recurrence-free survival of Group 1 in both all-NSCLC and adenocarcinoma subset. Cox proportional hazard model analysis also revealed that the 'presence of preoperative bronchoscopic cancer confirmation' dose not increase risk of recurrence in both NSCLC and adenocarcinoma subset. CONCLUSIONS It is unlikely that preoperative bronchoscopic cancer confirmation would increase recurrence risk in stage1A non-small cell lung cancer; however, a future prospective study with larger cohorts would be warranted to validate the results.
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Wijnenga MMJ, Mattni T, French PJ, Rutten GJ, Leenstra S, Kloet F, Taphoorn MJB, van den Bent MJ, Dirven CMF, van Veelen ML, Vincent AJPE. Does early resection of presumed low-grade glioma improve survival? A clinical perspective. J Neurooncol 2017; 133:137-146. [PMID: 28401374 PMCID: PMC5495869 DOI: 10.1007/s11060-017-2418-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/08/2017] [Indexed: 12/31/2022]
Abstract
Early resection is standard of care for presumed low-grade gliomas. This is based on studies including only tumors that were post-surgically confirmed as low-grade glioma. Unfortunately this does not represent the clinicians’ situation wherein he/she has to deal with a lesion on MRI that is suspect for low-grade glioma (i.e. without prior knowledge on the histological diagnosis). We therefore aimed to determine the optimal initial strategy for patients with a lesion suspect for low-grade glioma, but not histologically proven yet. We retrospectively identified 150 patients with a resectable presumed low-grade-glioma and who were otherwise in good clinical condition. In this cohort we compared overall survival between three types of initital treatment strategy: a wait-and-scan approach (n = 38), early resection (n = 83), or biopsy for histopathological verification (n = 29). In multivariate analysis, no difference was observed in overall survival for early resection compared to wait-and-scan: hazard ratio of 0.92 (95% CI 0.43–2.01; p = 0.85). However, biopsy strategy showed a shorter overall survival compared to wait-and-scan: hazard ratio of 2.69 (95% CI 1.19–6.06; p = 0.02). In this cohort we failed to confirm superiority of early resection over a wait-and-scan approach in terms of overall survival, though longer follow-up is required for final conclusion. Biopsy was associated with shorter overall survival.
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Affiliation(s)
- Maarten M J Wijnenga
- Department of Neuro-Oncology, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.
| | - Tariq Mattni
- Department of Neurosurgery, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands
| | - Pim J French
- Department of Neuro-Oncology, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands
| | - Geert-Jan Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Sieger Leenstra
- Department of Neurosurgery, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Fred Kloet
- Department of Neurosurgery, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Martin J van den Bent
- Department of Neuro-Oncology, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands
| | - Clemens M F Dirven
- Department of Neurosurgery, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands
| | - Marie-Lise van Veelen
- Department of Neurosurgery, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Erasmus MC Cancer Institute, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.
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Choi SH, Chae EJ, Shin SY, Kim EY, Kim JE, Lee HJ, Oh SY, Lee SM. Comparisons of clinical outcomes in patients with and without a preoperative tissue diagnosis in the persistent malignant-looking, ground-glass-opacity nodules. Medicine (Baltimore) 2016; 95:e4359. [PMID: 27559945 PMCID: PMC5400311 DOI: 10.1097/md.0000000000004359] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
To evaluate the clinical usefulness of surgical resection of persistent malignant-looking ground-glass-opacity nodules (GGN) without a preoperative tissue diagnosis.From September 1998 to November 2011, we retrospectively enrolled 288 patients (126 men, 162 women; mean age, 59.3 years) with lung adenocarcinoma proven by surgery and which appeared as GGN on chest computed tomography (CT, ground-glass-opacity [GGO] proportion >20%). We divided the study subjects into 2 groups: patients with a preoperative tissue diagnosis (PTD group, n = 207) and patients without a preoperative tissue diagnosis (No-PTD group, n = 81). In patients with GGN having GGO ≥ 90% (n = 140), we divided them into 2 groups: PTD group (n = 83) and No-PTD group (n = 57). The clinical and surgical outcomes were compared between the 2 groups.In 204 patients who underwent lobectomy for stage Ia lung cancer, there was no significantly different recurrence-free survival between the 2 groups (P = 0.721). A significantly lower percentage of No-PTD group waited >14 days for surgery (77.8% vs 87.9%, P = 0.030) and were hospitalized for >7 days (56.8% vs 89.9%, P < 0.001). They showed a shorter mean surgery time (136.9 vs 155.0 minutes, P = 0.019). In patients with GGN having GGO ≥ 90%, the results were the same as those of all of the study subjects.No-PTD group can gain benefits perioperatively, showing no different recurrence-free survival with PTD group in stage Ia lung cancer.
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Affiliation(s)
- Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
| | - Eun Jin Chae
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
- Correspondence: Eun Jin Chae, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-gu, Seoul 138-736, Korea (e-mail: )
| | - So Youn Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University
| | - Eun Young Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
- Department of Radiology, Chonbuk National University Medical School and Hospital, Research Institute of Clinical Medicine, Jeonju, Korea
| | - Ji-Eun Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
| | - Hyun Joo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
| | - Sang Young Oh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
| | - Sang Min Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center Seoul
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Jiang F, Jin T, Feng XL, Jin QF, Chen XZ. Repeat biopsy of primary disease negatively affects the outcome of patients with nasopharyngeal cancer treated with definitive intensity-modified radiotherapy: a cohort analysis of 795 patients. Jpn J Clin Oncol 2016; 46:435-40. [PMID: 26864132 DOI: 10.1093/jjco/hyw003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/03/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To determine whether pretreatment repeat biopsy of nasopharynx is associated with an impaired outcome in nasopharyngeal carcinoma patients in an intensity-modified radiotherapy era. METHODS We performed a retrospective data review of the association between pretreatment nasopharyngeal biopsy and outcomes for all nasopharyngeal carcinoma patients treated at our center between January 2007 and December 2011. Of the 720 patients enrolled, 693 (96.3%) were diagnosed after initial biopsy and 27 (3.7%) after repeat biopsy. Five-year cancer-specific survival, disease-free survival and distant metastasis-free survival for the two groups were compared using univariate and multivariate analyses to evaluate the effects of repeat biopsy on the outcome. RESULTS Five-year estimated cancer-specific survival (75.9 vs. 88.5%, P= 0.045) and disease-free survival (63.3 vs. 77.1%, P= 0.041) were significantly poorer in the repeat biopsy group than the initial biopsy group. After adjustment for other prognostic factors (age, gender, T and N stage), pretreatment biopsy remained independently associated with poorer both 5-year cancer-specific survival and disease-free survival. The hazard ratios for cancer-specific survival and disease-free survival in the repeat biopsy group were 2.73 (95% confidence interval 1.09-6.82) and 2.22 (95% confidence interval 1.12-4.37) compared with the initial biopsy group (reference), respectively. The repeat biopsy group also had a higher risk of distant failure compared with the initial biopsy group (hazard ratio 2.82, 95% confidence interval 1.22-6.51, P= 0.015). CONCLUSION Pretreatment repeat biopsy of nasopharynx has a detrimental effect on survivals of nasopharyngeal carcinoma patients, which may be partly due to an increased frequency of distant metastasis.
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Affiliation(s)
- Feng Jiang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Ting Jin
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xing-Lei Feng
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Qi-Feng Jin
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xiao-Zhong Chen
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
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Nakajima J. Preoperative pathological diagnosis of lung cancer: is it always necessary? Ann Thorac Cardiovasc Surg 2012; 18:183-5. [PMID: 22673553 DOI: 10.5761/atcs.ed.12.01892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Trisolini R, Paioli D, Patelli M. Is bronchoscopy dangerous in the pretreatment workup of non-small cell lung cancer patients? Chest 2006; 130:1284. [PMID: 17035478 DOI: 10.1378/chest.130.4.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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