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

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Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

Preoperative diagnostic interventions did not affect the relapse risk and prognosis, in this study cohort. Thus, preoperative diagnostic intervention is recommended if deemed necessary.

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Acknowledgements

We thank Mr. Hideyuki Kozuka and Ms. Tomoko Hasegawa for their assistance in data collection and Mr. Tomoki Kitawaki and Mr. Takayuki Kawaura for their assistance in data-analysis.

Funding

None declared.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan

    Yohei Taniguchi, Kento Fukumoto, Hiroshi Matsui, Tomohito Saito & Tomohiro Murakawa

  2. Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Kento Fukumoto

Authors
  1. Yohei Taniguchi
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  2. Kento Fukumoto
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  3. Hiroshi Matsui
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  4. Tomohito Saito
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  5. Tomohiro Murakawa
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Correspondence to Yohei Taniguchi.

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Taniguchi, Y., Fukumoto, K., Matsui, H. et al. Preoperative biopsy does not affect postoperative outcomes of resectable non-small cell lung cancer. Gen Thorac Cardiovasc Surg 67, 615–623 (2019). https://doi.org/10.1007/s11748-019-01062-1

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  • DOI: https://doi.org/10.1007/s11748-019-01062-1

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