Thorac cardiovasc Surg 2014; 62(07): 593-598
DOI: 10.1055/s-0034-1377062
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Value of Flexible Bronchoscopy for the Preoperative Assessment of NSCLC Diagnosed Using Percutaneous Core Needle Biopsy

Kyung-Wook Jo
1  Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
,
Hyeong Ryul Kim
2  Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
,
Dong Kwan Kim
2  Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
,
Yong-Hee Kim
2  Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
,
Seung-Il Park
2  Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
,
Se Hoon Choi
2  Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
,
Chang-Min Choi
1  Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
› Author Affiliations
Further Information

Publication History

18 January 2014

01 April 2014

Publication Date:
15 July 2014 (online)

Abstract

Background We aimed to investigate the value of routine flexible bronchoscopy (FB) for the preoperative assessment of early-stage non-small cell lung cancer (NSCLC) diagnosed using percutaneous core needle biopsy (PCNB).

Methods We enrolled 688 NSCLC patients who were treated at our hospital between January 2003 and December 2012 and who met the following criteria: (1) early-stage lung cancer (stage I or II); (2) lung cancer had been diagnosed using PCNB; and (3) no evidence of endobronchial disease in the airways other than the primary cancer site on both chest computed tomography (CT) and positron emission tomography-CT (PET-CT). All NSCLC patients were from the same tertiary referral center, where FB is routinely performed preoperatively for this disease, and their medical records were reviewed retrospectively.

Results Of the 688 patients included in the study, 451 (65.6%) were male and the median age was 65 years. Pathology analysis revealed that adenocarcinoma was the most frequently observed cell type (516/688, 75.0%). The distribution of preoperative clinical staging for the 688 patients was (1) IA (54.5%, 375/688); (2) IB (22.1%, 152/688); (3) IIA (18.2%, 125/688); and (4) IIB (5.2%, 36/688). The majority of these patients (95.2%, 655/688) underwent surgical resection. Unsuspected malignant endobronchial lesion on FB was found in only two cases (0.3%), and the surgical strategy had to be modified for both of these patients.

Conclusion Preoperative FB is not beneficial for screening the airways of almost any patient with early-stage NSCLC, provided that neither PET-CT nor CT reveal any evidence of endobronchial malignant involvement other than at the primary cancer site.