Jiro Abe1,2, Toshimasa Okazaki3,4, Naohiko Kikuchi3,4, Satomi Takahashi3, Akira Sakurada4, Yoshinori Okada4. 1. Department of Thoracic Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiote, Natori, Miyagi Prefecture, 981-1293, Japan. jabe@kmph.mfnet.ne.jp. 2. Department of Thoracic Surgery, Graduate School of Medicine, Tohoku University, 4-1 Seiryo-cho, Aoba-ward, Sendai, Miyagi Prefecture, 980-0872, Japan. jabe@kmph.mfnet.ne.jp. 3. Department of Thoracic Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiote, Natori, Miyagi Prefecture, 981-1293, Japan. 4. Department of Thoracic Surgery, Graduate School of Medicine, Tohoku University, 4-1 Seiryo-cho, Aoba-ward, Sendai, Miyagi Prefecture, 980-0872, Japan.
Abstract
OBJECTIVE: This study was conducted to evaluate the risk of recurrence possibly caused by preoperative bronchoscopic cancer confirmation in stage1A non-small cell lung cancer. METHODS: One hundred and seventy-nine cases of peripheral non-small cell lung cancer (including 151 adenocarcinoma) with no more than 3 cm in their tumor longer diameter were selected. All patients underwent preoperative diagnostic bronchoscopy followed by lobectomy, and were demonstrated to have pathologically free of lymph node involvement and pleural involvement. Radiological and pathological low-grade adenocarcinomas were excluded. Of 179 cases, 95 were confirmed lung cancer by bronchoscope (Group 1) and rest 84 had failed cancer confirmation by bronchoscope before surgery (Group 2). Forty-eight pairs for non-small cell lung cancer and 41 pairs for adenocarcinoma were identified from each group by propensity caliper matching. Kaplan-Meier method and log-rank test were performed on matched groups, and Cox proportional hazard model analysis was performed on whole matched cases. RESULTS: Log-rank test revealed no significant inferiority of recurrence-free survival of Group 1 in both all-NSCLC and adenocarcinoma subset. Cox proportional hazard model analysis also revealed that the 'presence of preoperative bronchoscopic cancer confirmation' dose not increase risk of recurrence in both NSCLC and adenocarcinoma subset. CONCLUSIONS: It is unlikely that preoperative bronchoscopic cancer confirmation would increase recurrence risk in stage1A non-small cell lung cancer; however, a future prospective study with larger cohorts would be warranted to validate the results.
OBJECTIVE: This study was conducted to evaluate the risk of recurrence possibly caused by preoperative bronchoscopic cancer confirmation in stage1A non-small cell lung cancer. METHODS: One hundred and seventy-nine cases of peripheral non-small cell lung cancer (including 151 adenocarcinoma) with no more than 3 cm in their tumor longer diameter were selected. All patients underwent preoperative diagnostic bronchoscopy followed by lobectomy, and were demonstrated to have pathologically free of lymph node involvement and pleural involvement. Radiological and pathological low-grade adenocarcinomas were excluded. Of 179 cases, 95 were confirmed lung cancer by bronchoscope (Group 1) and rest 84 had failed cancer confirmation by bronchoscope before surgery (Group 2). Forty-eight pairs for non-small cell lung cancer and 41 pairs for adenocarcinoma were identified from each group by propensity caliper matching. Kaplan-Meier method and log-rank test were performed on matched groups, and Cox proportional hazard model analysis was performed on whole matched cases. RESULTS: Log-rank test revealed no significant inferiority of recurrence-free survival of Group 1 in both all-NSCLC and adenocarcinoma subset. Cox proportional hazard model analysis also revealed that the 'presence of preoperative bronchoscopic cancer confirmation' dose not increase risk of recurrence in both NSCLC and adenocarcinoma subset. CONCLUSIONS: It is unlikely that preoperative bronchoscopic cancer confirmation would increase recurrence risk in stage1A non-small cell lung cancer; however, a future prospective study with larger cohorts would be warranted to validate the results.
Authors: Alain C Borczuk; Fang Qian; Angeliki Kazeros; Jennifer Eleazar; Adel Assaad; Joshua R Sonett; Mark Ginsburg; Lyall Gorenstein; Charles A Powell Journal: Am J Surg Pathol Date: 2009-03 Impact factor: 6.394
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