Preoperative biopsy does not affect postoperative outcomes of resectable non-small cell lung cancer

• DOI: 10.1007/s11748-019-01062-1
• Publication Date: 2019-01-18T15:31:35Z
• Authors: Yohei Taniguchi; Kento Fukumoto; Hiroshi Matsui; Tomohito Saito; Tomohiro Murakawa
• Keywords: Image-Guided Biopsy; Male; Lung Neoplasms; Disease-Free Survival; 3. Good health; Cohort Studies; Survival Rate; 03 medical and health sciences; Neoplasm Seeding; 0302 clinical medicine; Risk Factors; Carcinoma, Non-Small-Cell Lung; Humans; Female; Postoperative Period; Neoplasm Recurrence, Local; Pneumonectomy; Tomography, X-Ray Computed; Lung; Aged; Neoplasm Staging; Proportional Hazards Models; Retrospective Studies

Preoperative diagnostic interventions such as transbronchial biopsy and/or computed tomography-guided biopsy inevitably disrupt the lung structures and may disseminate tumour cells into the airway, vessels, or pleural cavity. Therefore, these procedures may affect the postoperative outcomes. Thus, we aimed to compare the survival outcomes in patients diagnosed by transbronchial biopsy vs computed tomography-guided biopsy vs lung resection.In a single-institution retrospective analysis, data from consecutive patients with cTanyN0M0 lung cancer, who underwent surgery between January 2006 and December 2012, were extracted by chart review. The overall and recurrence-free survivals of patients diagnosed by transbronchial biopsy, computed tomography-guided biopsy, and lung resection were compared using the univariate and multivariate Cox proportional hazard models. A stepwise backward elimination method, with a probability level of 0.15, was used to select the most powerful sets of outcome predictors.Transbronchial biopsy and/or computed tomography-guided biopsy were performed for larger and more advanced tumours, than lung resection (intra- or postoperative-diagnosis group). At crude analysis, transbronchial biopsy group and computed tomography-guided biopsy group showed higher probability of pleural dissemination, and worse prognosis than the lung resection group. At multivariate analysis, the diagnostic methods were not identified as independent risk factors of pleural dissemination, overall survival, or recurrence-free survival.Preoperative diagnostic interventions did not affect the relapse risk and prognosis, in this study cohort. Thus, preoperative diagnostic intervention is recommended if deemed necessary.