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Recurrence Risk Following Percutaneous Transthoracic Needle Biopsy in Patients Undergoing Sublobar Resection for
Yura Ahn1, Geun Dong Lee2, SeHoon Choi2
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
Preoperative needle biopsy may increase recurrence risk after lung cancer surgery. Percutaneous transthoracic needle biopsy (PTNB) is linked to higher local-regional recurrence, especially in the remnant lung, following sublobar resection for early-stage non-small cell lung cancer.
Area of Science:
- Thoracic Surgery
- Oncology
- Diagnostic Imaging
Background:
- The impact of preoperative percutaneous transthoracic needle biopsy (PTNB) on local-regional recurrence after sublobar resection for stage I non-small cell lung cancer (NSCLC) is not well-established.
- Understanding this relationship is crucial for optimizing treatment strategies and patient outcomes.
Purpose of the Study:
- To investigate the association between preoperative PTNB and recurrence patterns, including local-regional and distant recurrence, as well as overall survival (OS).
- To evaluate the specific impact of PTNB on different types of local-regional recurrence after sublobar resection in early-stage NSCLC.
Main Methods:
- A retrospective study included 2026 patients with pathologically confirmed stage I NSCLC who underwent sublobar resection.
- Propensity score matching (PSM) was used to balance patients who had PTNB with those who did not, controlling for 12 confounding factors.
- Cox proportional hazards regression analyzed the association of PTNB with recurrence (overall, local-regional, distant, remnant lung, ipsilateral pleural) and OS.
Main Results:
- In the PSM cohort (n=1144), PTNB was associated with increased overall recurrence (HR, 1.49) and local-regional recurrence (HR, 2.32).
- PTNB specifically increased the risk of remnant lung recurrence (HR, 2.07) but not ipsilateral pleural recurrence.
- No significant association was found between PTNB and distant recurrence or overall survival.
Conclusions:
- Preoperative PTNB is associated with a higher risk of local-regional recurrence, particularly in the remnant lung, in patients undergoing sublobar resection for stage I NSCLC.
- These findings suggest a potential need to reconsider the routine use of PTNB in this patient population.
- Further research may explore alternative diagnostic methods or modifications to biopsy techniques to mitigate recurrence risk.
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