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C.M. Park
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P1.13 - Radiology/Staging/Screening (ID 699)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.13-011d - Risk of Pleural Recurrence After Percutaneous Transthoracic Needle Biopsy in Stage I Non-Small Cell Lung Cancer: A Large Center Experience (ID 10019)
09:30 - 09:30 | Author(s): C.M. Park
- Abstract
Background:
To determine whether percutaneous transthoracic needle biopsy (PTNB) increase the risk of (a) isolated pleural recurrence and (b) concomitant pleural seeding and metastasis in stage I non-small cell lung cancer (NSCLC).
Method:
In this institutional review board-approved retrospective study, medical records of total of 830 consecutive patients with stage I NSCLC who underwent curative resection between 2004 and 2010 were reviewed. Median duration of follow-up was 1843 days (interquartile range, 1006-2734). Multiple logistic regression analyses were performed to identify risk factors of pleural recurrence.
Result:
Of 830 patients, 540 patients (65.1%) underwent PTNB before surgery, while 290 patients (34.9%) underwent non-PTNB procedures including bronchoscopic biopsy or exploratory thoracotomy. An isolated pleural recurrence was found in 26 patients (3.1%, [95%CI, 2.1-4.6%]) (20 in PTNB group, 6 in non-PTNB group). There was no significant association between PTNB and isolated pleural recurrence (P=0.197). Concomitant pleural recurrence occurred in 42 patients (5.1%, [95%CI, 3.8-6.8%]) (34 in PTNB group, and 8 in non-PTNB group). Subpleural location (p=0.007), tumor consistency (solid, part-solid, nonsolid) (p=0.046), PTNB (p=0.027), pathologic T stage (p<0.001), microscopic pleural invasion (p<0.001) and microscopic lymphatic invasion (p=0.019) were associated with concomitant pleural recurrence. The most significant factor of pleural recurrence was only microscopic pleural invasion (Odds Ratio, 4.28; 95% CI, 2.20 to 8.29) (P<0.001) on multiple logistic analysis. Among 540 patients undergoing PTNB, transfissural approach did not have significant association with pleural recurrence (P=0.220), while the most sole significant factor was microscopic pleural invasion (Odds Ratio, 3.40; 95% CI, 1.54 to 7.51) (P=0.002).
Conclusion:
PTNB did not increase the risk of isolated or concomitant pleural recurrence in early stage NSCLC. Higher incidence of concomitant pleural seeding in PTNB group was presumably attributed to peripheral lung cancer, potentially accompanying microscopic pleural invasion.
