Preoperative biopsy and tumor recurrence of stage I adenocarcinoma of the lung

Chien Sheng Huang, Po Kuei Hsu, Chun Ku Chen, Yi Chen Yeh, Hui Shan Chen, Mei Han Wu, Teh Ying Chou, Wen Hu Hsu, Chun Che Shih, Biing Shiun Huang

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Purpose: To evaluate whether preoperative biopsy affects the outcomes of patients undergoing at least lobectomy for stage I lung adenocarcinoma. Methods: We reviewed the medical records of patients who underwent surgery for stage I lung adenocarcinoma between 2006 and 2013. Tumor recurrence and survival were compared between patients who underwent preoperative biopsy, including computed tomographic-guided needle biopsy and transbronchial biopsy, and those who underwent intraoperative frozen section. Results: Among 509 patients, 229 patients (44.9%) underwent preoperative biopsy and 280 patients had lung adenocarcinoma diagnosed by intraoperative frozen section (reference group). Recurrence developed in 65 (12.8%) patients within a median follow-up period of 54.4 months. Multivariate analysis demonstrated that preoperative biopsy (OR 1.97, p = 0.045), radiological solid appearance (OR 5.43, p < 0.001), and angiolymphatic invasion (OR 2.48, p = 0.010) were independent predictors of recurrence. In the overall cohort, preoperative biopsy appeared to worsen 5-year disease-free and overall survival significantly (76.6% vs. 93.0%, p < 0.001; and 83.8% vs. 94.5%, p = 0.002, respectively) compared with the reference group. After propensity matching, multivariable logistic regression still identified preoperative biopsy as an independent predictor of overall recurrence (OR 2.21, p = 0.048) after adjusting for tumor characteristics. Conclusion: Preoperative biopsy might be considered a prognosticator of recurrence of stage I adenocarcinoma of the lungs in patients who undergo at least anatomic lobectomy without postoperative adjuvant chemotherapy.

Original languageEnglish
Pages (from-to)673-684
Number of pages12
JournalSurgery Today
Volume50
Issue number7
DOIs
Publication statusPublished - Jul 1 2020

Keywords

  • Disease-free survival
  • Early-stage lung cancer
  • Preoperative biopsy
  • Tumor recurrence

ASJC Scopus subject areas

  • Surgery

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