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Endobronchial ultrasound-guided transbronchial needle aspiration in patients with previously treated lung cancer

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Abstract

Purpose

The sampling and accurate diagnosis of lymph nodes during the clinical history of lung cancer are essential for selecting the appropriate treatment strategies. This study aims to evaluate the feasibility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with previously treated lung cancer.

Methods

Patients who underwent EBUS-TBNA after treatment for lung cancer were retrospectively reviewed. We classified the patients into two groups; Group 1 (G1): Indicated to have a recurrence of new lesions after radical surgery or chemo/radiotherapy with a curative intent; and Group 2 (G2): Indicated to have residual tumor cells after undergoing primary treatment for chemo/radiotherapy or re-staging after induction therapy prior to surgery.

Results

Seventy previously treated lung cancer cases (G1, n = 52; G2, n = 18) were enrolled. Thirty-two cases (61.5%) had recurrent disease in G1, and 9 cases (50.0%) had nodal metastasis in G2. The diagnostic accuracy was 95.2% in G1 and 88.9% in G2. Twenty-four cases were examined for epidermal growth factor receptor (EGFR) mutations, and 9 (37.5%) cases had mutations, including two cases with a T790M mutation. Furthermore, in one case, a re-biopsy revealed that the initial adenocarcinoma had transformed into small cell lung cancer.

Conclusion

Performing EBUS-TBNA during lung cancer treatment showed a high diagnostic yield. Samples obtained by EBUS-TBNA were helpful in determining when to perform repeat biomarker testing as well as for making pathological re-evaluations.

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Acknowledgement

We thank Ms. Fumie Saegusa (Cytotechnologist, Chiba University Hospital) for her support in the rapid on-site cytological evaluations.

Funding

This research is supported by a JSPS KAKENHI (Grant-in-Aid for Scientific Research (C)), Grant Number 17K10774 (T.N.) for the data analysis and preparation of the manuscript.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Taiki Fujiwara, Takahiro Nakajima, Terunaga Inage, Yuki Sata, Takayoshi Yamamoto, Yuichi Sakairi, Hironobu Wada, Hidemi Suzuki, Masako Chiyo & Ichiro Yoshino

Authors
  1. Taiki Fujiwara
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  2. Takahiro Nakajima
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  3. Terunaga Inage
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  4. Yuki Sata
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  5. Takayoshi Yamamoto
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  6. Yuichi Sakairi
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  7. Hironobu Wada
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  8. Hidemi Suzuki
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  9. Masako Chiyo
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  10. Ichiro Yoshino
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Corresponding author

Correspondence to Takahiro Nakajima.

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Conflict of interest

Takahiro Nakajima and Taiki Fujiwara received honoraria and lecture fees from Olympus medical systems for EBUS-TBNA training courses. These sponsors had no role in the study design, conduct of the study, data collection, data management and interpretation, preparation of the report, review of the report, or approval of the report.

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Fujiwara, T., Nakajima, T., Inage, T. et al. Endobronchial ultrasound-guided transbronchial needle aspiration in patients with previously treated lung cancer. Surg Today 51, 415–421 (2021). https://doi.org/10.1007/s00595-020-02101-8

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  • DOI: https://doi.org/10.1007/s00595-020-02101-8

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