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- Title
Risk of pleural recurrence after percutaneous transthoracic needle biopsy in stage I non-small-cell lung cancer.
- Authors
Ahn, Su Yeon; Yoon, Soon Ho; Yang, Bo Ram; Kim, Young Tae; Park, Chang Min; Goo, Jin Mo
- Abstract
<bold>Objectives: </bold>To determine whether percutaneous transthoracic needle biopsy (PTNB) increased the risk of pleural recurrence in stage I non-small-cell lung cancer (NSCLC).<bold>Methods: </bold>In this retrospective study, we reviewed 830 consecutive patients with stage I NSCLC who underwent curative resection between 2004 and 2010. Cox regression analyses with propensity score matching were performed to identify risk factors for pleural recurrence.<bold>Results: </bold>Of 830 patients, 540 (65.1%) underwent PTNB before surgery, while 290 (34.9%) underwent preoperative bronchoscopic biopsy or intraoperative wedge resection for a pathological diagnosis. Concomitant pleural recurrence occurred in 42 patients (5.1% [95% CI, 3.8-6.8]; 34 [6.3%] PTNB patients and eight [2.8%] non-PTNB patients) and isolated pleural recurrence took place in 26 patients (3.1% [95% CI, 2.1-4.6]; 20 [3.7%] PTNB patients and 6 [2.1%] non-PTNB patients). On multivariate analysis after matching, only visceral pleural invasion was associated with concomitant pleural recurrence (hazard ratio [HR]=3.367; 95% CI, 1.262-8.986; p=0.015) and isolated pleural recurrence (HR=3.216; 95% CI, 1.037-9.978; p=0.043), while PTNB was associated with neither concomitant nor isolated pleural recurrence (p=0.605 and p=0.963, respectively). Among 540 patients undergoing PTNB, the transfissural approach did not have a significant association with pleural recurrence (p=0.539 and p=0.313, respectively); instead, visceral pleural invasion and microscopic lymphatic invasion were significantly associated with concomitant pleural recurrence, and microscopic lymphatic invasion was associated with isolated pleural recurrence (p<0.05).<bold>Conclusion: </bold>PTNB did not significantly increase the risk of pleural recurrence in stage I NSCLC, whereas visceral pleural invasion was responsible for pleural recurrence.<bold>Key Points: </bold>• PTNB did not significantly increase the risk of pleural recurrence in stage I NSCLC, whereas visceral pleural invasion was responsible for pleural recurrence. • The transfissural approach in PTNB did not increase the risk of pleural recurrence. • PTNB can be performed for the confirmatory diagnosis of peripheral stage I lung cancer without concern for the risk of pleural recurrence.
- Subjects
NON-small-cell lung carcinoma; NEEDLE biopsy; REGRESSION analysis; MULTIVARIATE analysis; LYMPHATIC infections; CANCER relapse; CANCER invasiveness; LUNG cancer; LUNG tumors; METASTASIS; TUMOR classification; PLEURAL tumors; PROPORTIONAL hazards models; RETROSPECTIVE studies
- Publication
European Radiology, 2019, Vol 29, Issue 1, p270
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5561-5