BACKGROUND: Second lung primaries occur at a rate of up to 3% per patient-year after curative resection for non-small-cell lung carcinoma. Postresection patients are often poor candidates for further curative surgery because of their diminished pulmonary reserve. The aim of this study was to evaluate the role of fluorescence bronchoscopy by using the Xillix LIFE-Lung Fluorescence Endoscopy System to identify second lung primaries in patients who have had a previous curative resection of a non-small-cell lung cancer. METHODS: Patients who had no evidence of disease status after resection of a non-small-cell lung cancer were identified from a prospectively collected data base and entered onto a fluorescence bronchoscopy surveillance protocol. All suspicious areas, as well as several areas of apparently normal mucosa, were sampled for biopsy. A single pathologist reviewed all biopsy specimens, with 10% of biopsies re-reviewed, for quality control, by a second pulmonary pathologist. RESULTS: A total of 31 surveillance fluorescence bronchoscopies were performed on 25 patients after conventional bronchoscopy. Four intraepithelial neoplasias or invasive carcinomas were identified in 3 (12%) of 25 patients screened. The addition of the LIFE examination to conventional bronchoscopy increased the sensitivity of screening from 25.0% to 75.0%, which yielded a relative sensitivity of 300% with a negative predictive value of .97. CONCLUSIONS: Use of postresection surveillance with fluorescence bronchoscopy identified intraepithelial or invasive lesions in 12% of non-small-cell lung cancer patients, and the system was three times more sensitive than conventional bronchoscopy to identify these early mucosal lesions. Fluorescence bronchoscopic surveillance of this high-risk, postresection population will help better define the true rate of occurrence and the natural history of second primaries and may assist in monitoring their response to newer, noninvasive treatment methods, such as photodynamic therapy or chemopreventive agents, in future trials.
BACKGROUND: Second lung primaries occur at a rate of up to 3% per patient-year after curative resection for non-small-cell lung carcinoma. Postresection patients are often poor candidates for further curative surgery because of their diminished pulmonary reserve. The aim of this study was to evaluate the role of fluorescence bronchoscopy by using the Xillix LIFE-Lung Fluorescence Endoscopy System to identify second lung primaries in patients who have had a previous curative resection of a non-small-cell lung cancer. METHODS:Patients who had no evidence of disease status after resection of a non-small-cell lung cancer were identified from a prospectively collected data base and entered onto a fluorescence bronchoscopy surveillance protocol. All suspicious areas, as well as several areas of apparently normal mucosa, were sampled for biopsy. A single pathologist reviewed all biopsy specimens, with 10% of biopsies re-reviewed, for quality control, by a second pulmonary pathologist. RESULTS: A total of 31 surveillance fluorescence bronchoscopies were performed on 25 patients after conventional bronchoscopy. Four intraepithelial neoplasias or invasive carcinomas were identified in 3 (12%) of 25 patients screened. The addition of the LIFE examination to conventional bronchoscopy increased the sensitivity of screening from 25.0% to 75.0%, which yielded a relative sensitivity of 300% with a negative predictive value of .97. CONCLUSIONS: Use of postresection surveillance with fluorescence bronchoscopy identified intraepithelial or invasive lesions in 12% of non-small-cell lung cancerpatients, and the system was three times more sensitive than conventional bronchoscopy to identify these early mucosal lesions. Fluorescence bronchoscopic surveillance of this high-risk, postresection population will help better define the true rate of occurrence and the natural history of second primaries and may assist in monitoring their response to newer, noninvasive treatment methods, such as photodynamic therapy or chemopreventive agents, in future trials.
Authors: Jonathan P Celli; Bryan Q Spring; Imran Rizvi; Conor L Evans; Kimberley S Samkoe; Sarika Verma; Brian W Pogue; Tayyaba Hasan Journal: Chem Rev Date: 2010-05-12 Impact factor: 60.622
Authors: Bojan Zaric; Branislav Perin; Heinrich D Becker; Felix Fj Herth; Ralf Eberhardt; Svetlana Jovanovic; Tihomir Orlic; Milana Panjkovic; Biljana Zvezdin; Aleksandra Jovelic; Milorad Bijelovic; Vladimir Jurisic; Milan Antonic Journal: Med Oncol Date: 2011-08-09 Impact factor: 3.064
Authors: Stephen Lam; Beau Standish; Corisande Baldwin; Annette McWilliams; Jean leRiche; Adi Gazdar; Alex I Vitkin; Victor Yang; Norihiko Ikeda; Calum MacAulay Journal: Clin Cancer Res Date: 2008-04-01 Impact factor: 12.531