Tae Hee Kim1, Darren Buonocore2, Elena Nadia Petre1, Jeremy C Durack1, Majid Maybody1, Rocio P Johnston3, William D Travis2, Prasad S Adusumilli4, Stephen B Solomon1, Etay Ziv5. 1. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York. 2. Thoracic Pathology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. 3. Body Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York. 4. Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. 5. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: zive@mskcc.org.
Abstract
BACKGROUND: Lung adenocarcinoma histologic subtype is an important indicator of patient outcomes, so preoperative knowledge of subtype may be helpful to guide surgical planning. We evaluated the sensitivity and prognostic efficacy of specimens from computed tomography-guided core needle biopsies to predict histologic subtype and patient outcome after surgery. METHODS: We retrospectively identified 221 patients with lung adenocarcinoma who underwent computed tomography-guided lung biopsy and subsequent surgical resection. Concordance, accuracy, specificity, and sensitivity of histologic subtypes from core biopsy specimens were compared with surgically resected specimens. Tumor characteristics and biopsy procedural factors were analyzed to determine impact on diagnostic sensitivity. Histologic subtype based on biopsy specimen, clinical, tumor, and treatment variables were also examined in relation to time to progression. RESULTS: Overall concordance of biopsy samples with the predominant subtype from surgical specimens was 77%. Specificity (sensitivity) of detecting a nonaggressive and aggressive subtype were 86% (93%) and 95% (48%), respectively. Length of core specimen and percentage subtype composition in the surgically resected specimen were correlated with improved sensitivity but to a lesser extent with aggressive subtypes. Presence of an aggressive subtype in biopsy specimens was an independent predictor of progression after surgery (subdistribution hazard ratio, 2.51; 95% confidence interval, 1.28-4.94; p = 0.0075). CONCLUSIONS: Specimens from computed tomography-guided core biopsies can predict lung adenocarcinoma progression after surgical resection. Future prospective studies should address the role of core biopsy in preoperative planning.
BACKGROUND:Lung adenocarcinoma histologic subtype is an important indicator of patient outcomes, so preoperative knowledge of subtype may be helpful to guide surgical planning. We evaluated the sensitivity and prognostic efficacy of specimens from computed tomography-guided core needle biopsies to predict histologic subtype and patient outcome after surgery. METHODS: We retrospectively identified 221 patients with lung adenocarcinoma who underwent computed tomography-guided lung biopsy and subsequent surgical resection. Concordance, accuracy, specificity, and sensitivity of histologic subtypes from core biopsy specimens were compared with surgically resected specimens. Tumor characteristics and biopsy procedural factors were analyzed to determine impact on diagnostic sensitivity. Histologic subtype based on biopsy specimen, clinical, tumor, and treatment variables were also examined in relation to time to progression. RESULTS: Overall concordance of biopsy samples with the predominant subtype from surgical specimens was 77%. Specificity (sensitivity) of detecting a nonaggressive and aggressive subtype were 86% (93%) and 95% (48%), respectively. Length of core specimen and percentage subtype composition in the surgically resected specimen were correlated with improved sensitivity but to a lesser extent with aggressive subtypes. Presence of an aggressive subtype in biopsy specimens was an independent predictor of progression after surgery (subdistribution hazard ratio, 2.51; 95% confidence interval, 1.28-4.94; p = 0.0075). CONCLUSIONS: Specimens from computed tomography-guided core biopsies can predict lung adenocarcinoma progression after surgical resection. Future prospective studies should address the role of core biopsy in preoperative planning.
Authors: Ahmed Elsakka; Elena N Petre; Fourat Ridouani; Mario Ghosn; Matthew J Bott; Bryan C Husta; Maria E Arcila; Erica Alexander; Stephen B Solomon; Etay Ziv Journal: JTO Clin Res Rep Date: 2022-05-18
Authors: Timothy J Young; Ramin Salehi-Rad; Reza Ronaghi; Jane Yanagawa; Puja Shahrouki; Bianca E Villegas; Brian Cone; Gregory A Fishbein; William D Wallace; Fereidoun Abtin; Igor Barjaktarevic Journal: Med Sci (Basel) Date: 2022-06-22