Recommendation of proper follow-up for peripheral pulmonary lesions with non-malignant result by bronchoscopy

Most of the patients who suspected malignant peripheral pulmonary lesions (PPLs) on the chest image undergo bronchoscopy at our cancer center. However, it is well-known difficult to diagnose PPLs as true benign by bronchoscopy. We researched what the proper follow-up after bronchoscopy for the cases with non-malignant result.Consecutive patients who underwent bronchoscopy with radial endobronchial ultrasound (R-EBUS) for PPLs at our hospital from January to December 2014 were collected. Cases with non-malignant result even though R-EBUS detected the PPLs were reviewed concerning their clinical factors and clinical courses.Among 125 eligible patients, organizing pneumonia and mycobacteriosis were all correct (n=18). In the remaining 107 cases, final diagnosis was malignant in 58 (54.2%). In a univariate analysis, part-solid compared to solid feature was the only significant factor correlated the malignant result (77.4 % vs.44.7 %, p=0.002). Meanwhile, 67 cases continued follow-up while 37 cases underwent rebiopsy or surgery, and 3 cases completed medical care due to doctors’ decision. On the first follow-up CT (taken at median: 84 [range: 14-308] days) of the 67 cases, 17 PPLs decreased in size were finally benign. Conversely, most of PPLs increased in size at any timing were finally malignant (n=12), so rebiopsy or surgery was considered then. By receiver operating characteristic analysis, the maximum effective timing of the first CT was 91 days after, and total follow-...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research