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Published in: European Radiology 1/2019

01-01-2019 | Chest

Risk of pleural recurrence after percutaneous transthoracic needle biopsy in stage I non-small-cell lung cancer

Authors: Su Yeon Ahn, Soon Ho Yoon, Bo Ram Yang, Young Tae Kim, Chang Min Park, Jin Mo Goo

Published in: European Radiology | Issue 1/2019

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Abstract

Objectives

To determine whether percutaneous transthoracic needle biopsy (PTNB) increased the risk of pleural recurrence in stage I non-small-cell lung cancer (NSCLC).

Methods

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.

Results

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).

Conclusion

PTNB did not significantly increase the risk of pleural recurrence in stage I NSCLC, whereas visceral pleural invasion was responsible for pleural recurrence.

Key Points

• 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.
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Metadata
Title
Risk of pleural recurrence after percutaneous transthoracic needle biopsy in stage I non-small-cell lung cancer
Authors
Su Yeon Ahn
Soon Ho Yoon
Bo Ram Yang
Young Tae Kim
Chang Min Park
Jin Mo Goo
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5561-5

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