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Therapeutic bronchoscopy for pulmonary lymphoma: data from the EpiGETIF registry
Luigi Olivati1, Julie Tronchetti2, Jean-Baptiste Lovato2
1Interventional Pulmonology Department, North University Hospital, Marseille, France; Pulmonology Department, Department of Medicine and Surgery, Respiratory Disease and Lung function Unit, University of Parma, Parma, Italy.
Background:
Tracheobronchial lymphoma is a rare, life-threatening condition where chemo- or radiotherapy efficacy may be delayed. Therapeutic bronchoscopy (TB) may provide rapid airway stabilisation, but data on outcomes remain limited.
Methods:
We conducted a multicentre retrospective study of 32 patients undergoing TB (December 2018-June 2024). Clinical, radiological, and endoscopic variables were analysed using descriptive statistics and Kaplan-Meier curves.
Results:
32 patients were included (63% male, mean age 66 ± 21 years). 26 patients (83%) were treatment-naïve; 18 (56%) had an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-1. The most frequent presenting symptoms were dyspnoea (mean Borg score 6 ± 2.6) and cough (87%). 15 patients (47%) required oxygen therapy at baseline. Computed tomography (CT) showed airway obstruction in most patients; atelectasis occurred in 14%. Procedures lasted a mean of 57 ± 45 min; complete procedural success was achieved in 78% of cases. Mechanical debulking (66%) and stent placement (78%) were the most commonly applied interventions. Complications occurred in 22%, correlating significantly with pre-procedure oxygen therapy (p = 0.014). Clinical improvement occurred in 83%; the mean Borg score decreased from 6 ± 2.6 to 1.4 ± 1.3 (p < 0.01). Median survival was 462 days overall (556 days in treatment-naïve and 117 days in previously treated patients). Monthly mortality showed a significant decreasing trend over time (p = 0.0023). Patients with ECOG PS ≥ 2 had significantly lower survival compared with those with ECOG PS < 2 (p < 0.01). Most lymphomas were B-cell (85%), and bronchoscopy established the diagnosis in 96% of patients without prior histology.
Conclusions:
TB achieves high procedural success and provides meaningful clinical improvement in patients with tracheobronchial lymphoma. Patient outcomes are strongly influenced by baseline performance status and previous therapies. These results emphasise the importance of conducting prospective studies to more clearly define the role of bronchoscopy within the multidisciplinary management of this rare disease.
