Extract
In terms of previous experience, endoscopy plays a leading role in diagnosis of early central lung cancer, which rapidly and effectively detects changes of tracheobronchial tree mucosa at the initial stages of carcinogenesis [1]. Nevertheless, the most recent SELEPREBB trial published in the European Respiratory Journal [2] revealed that intensive bronchoscopy surveillance using autofluorescence imaging in patients with mild or moderate dysplasia did not improve their outcomes for developing lung cancer in the long term. 13 patients (3.6%) developed a persistent carcinoma in situ (CIS) or an invasive lung cancer in this randomised prospective multicentre study during the 36 months of follow-up; eight of them were with a minor or moderate dysplasia at baseline, but preventive local treatment or follow-up did not significantly affect the outcome. This result answered the question that American College of Chest Physicians asked years ago: “Patients with bronchial epithelial dysplasia or CIS may be treated endobronchially; however, it remains unclear if these therapies are associated with improved patient outcomes” [3]. We find the negative end-point needs further discussion in several aspects.
Abstract
The utility of repeated bronchoscopy for surveillance of bronchial low-grade preinvasive lesions in high-risk patients is quite limited in SELEPREBB trial. More selected risky patients or combination with CT imaging could be a direction of further research. https://bit.ly/3PsuJ7i
Footnotes
Conflict of interest: The authors declare no competing interests.
- Received November 25, 2022.
- Accepted December 10, 2022.
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