Abstract
Background
In case of the patients with lung nodule without preoperative diagnosis, the next strategies to make diagnosis as malignancy will be INB or frozen histology by wedge resection. However, it is controversial to perform INB, especially using cutting type needles, because of the risk of recurrence.
Methods
We classified the p-stage I lung cancer patients in our hospital between 2008 to 2012 into the following 3 groups according to the diagnostic methods; Group A(n=46): Bronchoscopy and/or CT guided fine needle aspiration(CT-FNA)(22G), Group B(n=28): INB(18G automatic biopsy gun with a cutting type needle), Group C(n=12): wedge resection. To investigate the difference of the probability for relapse, we retrospectively reviewed their medical records and compared the overall survival(OS) and the relapse free survival(RFS).
Results
There was no difference in age, gender, histological types, pathological status (pl/ly/v), operative time, blood loss and duration of hospital stays between 3 groups, although tumor diameter was significantly greater in Group A(P=0.008). The number of patients who grew recurrences in Group A, B and C was 5, 9 and 0 respectively, and Group B showed significant frequency of relapse(P=0.016). The 3-year RFS of Group A, B and C were 84%, 67% and 100% respectively. The Log rank test showed a significant difference among the 3 groups in RFS (P=0.034 ).
Conclusions
Our study showed INB using a cutting type needle might elevate the risk or recurrence. We have to be very careful about the indication for INB. It seems necessary to discuss the procedure for INB such as the number of puncture and the type of needles for reducing the risk of relapse.
- © 2014 ERS
