RT Journal Article
SR Electronic
T1 Risk of lung cancer in patients with preinvasive bronchial lesions followed by autoflurescence bronchoscopy and chest computed tomography
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p1974
VO 38
IS Suppl 55
A1 Alaa Mohamed
A1 Shibuya Kiyoshi
A1 T. Fujiwara
A1 W. Hironobu
A1 H. Hoshino
A1 S. Yoshida
A1 M. Suzuki
A1 K. Hiroshima
A1 Y. Nakatani
A1 Aliae Mohamed-Hussein
A1 Maha Elkouly
A1 Tarek Mahfouz
A1 I. Yochino
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p1974.abstract
AB Introduction and aim of the work: To assess risk of lung cancer (LC) in patients with preinvasive bronchial lesions and to identify factors associated with higher risk.Patients and methods: 124 patients with one or more preinvasive bronchial lesions and normal chest computed tomography (CT) (mean age 66.7 years, 121 males and 3 females), followed-up by white light and autofluorescence bronchoscopy (AFB) every 4-6 mo and chest CT every 6-12 mo, end points were development of carcinoma in situ (CIS) or LC.Results: Among 124 patients with 240 preinvasive bronchial lesions, 20 CIS or LC lesions were detected during follow-up in 20 (16%) patients, 7 were detected as new endobronchial lesions, 10 as new peripheral lesions and 3 as local progression from severe dysplasia to CIS. Median time to progression was 24 months (range: 6-54 mo). The Cumulative risk of progression was 7% at one year, 20% at three years and 44% at 5 years. Among detected lung cancers, 80% were stage 0 or stage1 and underwent treatment with curative intent. Diagnosis of new SD during follow-up (p=0.0001), chronic obstructive pulmonary disease (COPD) (p = 0.001) or smoking index >52 packyear (p = 0.042) was associated with higher risk. Even after controlling for other risk factors,COPD was associated with risk of progression. Baseline lesion grade was not predictive of patient outcome (p = 0.146).Conclusions: Patients with preinvasive bronchial lesions, especially those with new SD during follow-up, COPD or smoking >52 pack-year are at high risk of LC, AFB and CT follow-up facilitated early detection and treatment with curative intent.