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.
Keywords
bronchoscopy - NSCLC - PET-CT - CT
