CT-guided needle biopsy is not associated with increased ipsilateral pleural metastasis

IF 4.5 2区 医学 Q1 ONCOLOGY Lung Cancer Pub Date : 2024-07-14 DOI:10.1016/j.lungcan.2024.107890
Benedikt Niedermaier , Yao Kou , Elizabeth Tong , Monika Eichinger , Laura V. Klotz , Martin E. Eichhorn , Thomas Muley , Felix Herth , Hans-Ulrich Kauczor , Claus Peter Heußel , Hauke Winter
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Abstract

Introduction

Histological confirmation of a lung tumor is the prerequisite for treatment planning. It has been suspected that CT-guided needle biopsy (CTGNB) exposes the patient to a higher risk of pleural recurrence. However, the distance between tumor and pleura has largely been neglected as a possible confounder when comparing CTGNB to bronchoscopy.

Methods

All patients with lung cancer histologically confirmed by bronchoscopy or CTGNB between 2010 and 2020 were enrolled and studied. Patients’ medical histories, radiologic and pathologic findings and surgical records were reviewed. Pleural recurrence was diagnosed by pleural biopsy, fluid cytology, or by CT chest imaging showing progressive pleural nodules.

Results

In this retrospective unicenter analysis, 844 patients underwent curative resection for early-stage lung cancer between 2010 and 2020. Median follow-up was 47.5 months (3–137). 27 patients (3.2 %) with ipsilateral pleural recurrence (IPR) were identified. The distance of the tumor to the pleura was significantly smaller in patients who underwent CTGNB. A tendency of increased risk of IPR was observed in tumors located in the lower lobe (HR: 2.18 [±0.43], p = 0.068), but only microscopic pleural invasion was a significant independent predictive factor for increased risk of IPR (HR: 5.33 [± 0.51], p = 0.001) by multivariate cox analysis. Biopsy by CTGNB did not affect IPR (HR: 1.298 [± 0.39], p = 0.504).

Conclusion

CTGNB is safe and not associated with an increased incidence of IPR in our cohort of patients. This observation remains to be validated in a larger multicenter patient cohort.

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CT 引导下的针刺活检与同侧胸膜转移增加无关
导言肺部肿瘤的组织学确诊是制定治疗计划的先决条件。人们一直怀疑 CT 引导下针刺活检(CTGNB)会增加患者胸膜复发的风险。然而,在比较 CTGNB 与支气管镜检查时,肿瘤与胸膜之间的距离作为一个可能的混杂因素在很大程度上被忽视了。研究方法:对 2010-2020 年间所有经支气管镜检查或 CTGNB 组织学确诊的肺癌患者进行登记和研究。研究人员回顾了患者的病史、放射学和病理学检查结果以及手术记录。胸膜复发是通过胸膜活检、胸腔积液细胞学检查或胸部CT成像显示进行性胸膜结节来诊断的。中位随访时间为 47.5 个月(3-137)。27名患者(3.2%)出现同侧胸膜复发(IPR)。接受 CTGNB 的患者肿瘤与胸膜的距离明显较小。通过多变量考克斯分析发现,位于下叶的肿瘤发生 IPR 的风险有增加的趋势(HR:2.18 [±0.43],p = 0.068),但只有微小胸膜侵犯才是 IPR 风险增加的重要独立预测因素(HR:5.33 [±0.51],p = 0.001)。CTGNB活检不会影响IPR(HR:1.298 [±0.39],P = 0.504)。这一观察结果还有待在更大规模的多中心患者队列中进行验证。
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来源期刊
Lung Cancer
Lung Cancer 医学-呼吸系统
CiteScore
9.40
自引率
3.80%
发文量
407
审稿时长
25 days
期刊介绍: Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.
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