Long-term outcomes of virtual-assisted lung mapping compared with CT-guided percutaneous marking

Area of Science:

• Pulmonology
• Surgical Oncology
• Medical Imaging

Background:

• Pulmonary nodules often require precise localization for curative resection.
• Identifying nodules intraoperatively can be challenging, impacting surgical outcomes.
• Virtual-assisted lung mapping (VAL-MAP) is a bronchoscopic technique using virtual images for precise marking.

Purpose of the Study:

• To compare the long-term oncologic outcomes of VAL-MAP with computed tomography (CT)-guided percutaneous marking.
• To evaluate the efficacy of VAL-MAP in reducing local recurrence rates after pulmonary resection.

Main Methods:

• Retrospective observational study of 213 patients undergoing curative pulmonary resection (1998-2018).
• Comparison between patients who underwent VAL-MAP and those who had CT-guided localization.
• Evaluation of local recurrence rate and local recurrence-free survival.

Main Results:

• VAL-MAP group showed a significantly lower 5-year local recurrence rate (2.9% vs. 11.1%) compared to CT-guided localization.
• Among patients with metastatic lung tumors undergoing sublobar resection, VAL-MAP was associated with a lower local recurrence rate (P=0.03) and higher 5-year local recurrence-free survival (65.5% vs. 36.4%).
• Local recurrence was observed in three patients with metastatic tumors in the VAL-MAP group, but none with primary lung cancer.

Conclusions:

• VAL-MAP demonstrates superior long-term oncologic outcomes compared to CT-guided percutaneous marking.
• VAL-MAP is an effective method for reducing local recurrence and improving local recurrence-free survival, particularly for metastatic lung tumors.
• The technique aids in precise localization of pulmonary nodules, enhancing resection efficacy.