Recurrence risk after preoperative biopsy in patients with resected early-stage non-small-cell lung cancer: a retrospective study
Authors Hu CP, Jiang J, Li YY, Zhang CF, Zhang WX, Jiang HH, Gao Y, Zhuang W, Lei KB, Tang Y, Wan RJ
Received 28 February 2018
Accepted for publication 1 May 2018
Published 6 July 2018 Volume 2018:10 Pages 1927—1934
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Antonella D'Anneo
Chengping Hu,1 Juan Jiang,1 Yuanyuan Li,1 Chunfang Zhang,2 Weixing Zhang,2 Haihe Jiang,2 Yang Gao,2 Wei Zhuang,2 Kaibo Lei,2 Yong Tang,2 Rongjun Wan1
1Department of Respiratory and Critical Care Medicine, National Key Clinical Specialty, Xiangya Hospital, Central South University, Changsha, China; 2Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China
Background: Tumor cell dissemination after needle biopsy has been reported in a variety of malignancies, including non-small-cell lung cancer (NSCLC). However, there is little clinical evidence in regard to whether preoperative biopsy increases the risk of recurrence in completely resected NSCLC.
Patients and methods: A total of 322 patients diagnosed as pathological stage I NSCLC using intraoperative biopsy (IOB) (control group), preoperative percutaneous needle biopsy (PNB) or bronchoscopic biopsy were included in this study. Baseline characteristics were collected and compared. The disease-free survival (DFS) of patients was analyzed using Kaplan–Meier method. Subgroup analysis and Cox regression were performed to evaluate the effect of preoperative biopsy on recurrence risk with adjustment for potential confounders.
Results: Among these patients, 202 (63%) underwent IOB, 66 (20%) underwent PNB, and 54 (17%) underwent bronchoscopic biopsy. DFS of patients who had preoperative PNB or bronchoscopic biopsy was similar to those who had IOB (P=0.514 and 0.869). Neither preoperative PNB nor transbronchial biopsy significantly affected recurrence incidence across all the relevant subgroups. Furthermore, multivariate analysis showed that preoperative biopsy was not associated with increased recurrence risk in NSCLC patients with adjustment for confounders, while squamous cell carcinoma and adjuvant chemotherapy were associated with prolonged DFS.
Conclusion: Neither preoperative PNB nor bronchoscopic biopsy increased the recurrence risk in patients with resected stage I NSCLC, indicating that these procedures could be safely used for diagnosis of early-stage NSCLC.
Keywords: non-small-cell lung cancer, biopsy, recurrence, percutaneous needle biopsy, bronchoscopy, surgery
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