Impact of preoperative diagnostic biopsy procedure on spread through air spaces and related outcomes in resected stage I non-small cell lung cancer

This study aimed to analyze the unexplored correlation between preoperative biopsy procedure and a higher risk of STAS and its impact on STAS-related outcomes in resected stage I non-small cell lung cancer (NSCLC).RESEARCH QUESTION: Does preoperative biopsy procedure affect the risk of STAS and STAS-related outcomes in surgically treated stage I NSCLC?STUDY DESIGN AND METHODS: We examined 2,169 patients who underwent surgery for pathologic stage I NSCLC during January 2011-December 2019 at the Seoul National University Bundang Hospital, a tertiary center in South Korea. Factors including percutaneous needle biopsy (PCNB) and bronchoscopic biopsy were assessed for determining the association between preoperative biopsy and an elevated risk of STAS. In addition, the impact of preoperative biopsy on STAS-related prognosis (recurrence and lung cancer-specific mortality) was evaluated with multivariable Cox regression analyses.RESULTS: STAS was positive in 638/2,169 (29.4%) patients. There was an insignificant association between preoperative biopsy (both PCNB and bronchoscopic biopsy) and STAS. After adjustments for preoperative tumor biopsy, STAS was a significant risk factor for cancer recurrence (hazard ratio [HR]=1.72, 95% confidence interval [CI]=1.20-2.48). Additionally, sublobar resection remained a significant risk factor for recurrence (HR=3.20, 95% CI 1.65-6.21) and lung cancer-specific mortality (HR=12.71, 95% CI=3.68-43.92) in STAS-positive cases. However, this associ...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research