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Surgery Today
Published in: Surgery Today 7/2020

01-07-2020 | NSCLC | Original Article

Preoperative biopsy and tumor recurrence of stage I adenocarcinoma of the lung

Authors: Chien-Sheng Huang, Po-Kuei Hsu, Chun-Ku Chen, Yi-Chen Yeh, Hui-Shan Chen, Mei-Han Wu, Teh-Ying Chou, Wen-Hu Hsu, Chun-Che Shih, Biing-Shiun Huang

Published in: Surgery Today | Issue 7/2020

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Abstract

Purpose

To evaluate whether preoperative biopsy affects the outcomes of patients undergoing at least lobectomy for stage I lung adenocarcinoma.

Methods

We reviewed the medical records of patients who underwent surgery for stage I lung adenocarcinoma between 2006 and 2013. Tumor recurrence and survival were compared between patients who underwent preoperative biopsy, including computed tomographic-guided needle biopsy and transbronchial biopsy, and those who underwent intraoperative frozen section.

Results

Among 509 patients, 229 patients (44.9%) underwent preoperative biopsy and 280 patients had lung adenocarcinoma diagnosed by intraoperative frozen section (reference group). Recurrence developed in 65 (12.8%) patients within a median follow-up period of 54.4 months. Multivariate analysis demonstrated that preoperative biopsy (OR 1.97, p = 0.045), radiological solid appearance (OR 5.43, p < 0.001), and angiolymphatic invasion (OR 2.48, p = 0.010) were independent predictors of recurrence. In the overall cohort, preoperative biopsy appeared to worsen 5-year disease-free and overall survival significantly (76.6% vs. 93.0%, p < 0.001; and 83.8% vs. 94.5%, p = 0.002, respectively) compared with the reference group. After propensity matching, multivariable logistic regression still identified preoperative biopsy as an independent predictor of overall recurrence (OR 2.21, p = 0.048) after adjusting for tumor characteristics.

Conclusion

Preoperative biopsy might be considered a prognosticator of recurrence of stage I adenocarcinoma of the lungs in patients who undergo at least anatomic lobectomy without postoperative adjuvant chemotherapy.
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Metadata
Title
Preoperative biopsy and tumor recurrence of stage I adenocarcinoma of the lung
Authors
Chien-Sheng Huang
Po-Kuei Hsu
Chun-Ku Chen
Yi-Chen Yeh
Hui-Shan Chen
Mei-Han Wu
Teh-Ying Chou
Wen-Hu Hsu
Chun-Che Shih
Biing-Shiun Huang
Publication date
01-07-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 7/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01941-3

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