| 1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin 2024;74:12-49. |
Review/Other-Dx |
N/A |
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries (through 2020) and mortality data collected by the National Center for Health Statistics (through 2021). In 2024, 2,001,140 new cancer cases and 611,720 cancer deaths are projected to occur in the United States. Cancer mortality continued to decline through 2021, averting over 4 million deaths since 1991 because of reductions in smoking, earlier detection for some cancers, and improved treatment options in both the adjuvant and metastatic settings. However, these gains are threatened by increasing incidence for 6 of the top 10 cancers. Incidence rates increased during 2015-2019 by 0.6%-1% annually for breast, pancreas, and uterine corpus cancers and by 2%-3% annually for prostate, liver (female), kidney, and human papillomavirus-associated oral cancers and for melanoma. Incidence rates also increased by 1%-2% annually for cervical (ages 30-44 years) and colorectal cancers (ages <55 years) in young adults. Colorectal cancer was the fourth-leading cause of cancer death in both men and women younger than 50 years in the late-1990s but is now first in men and second in women. Progress is also hampered by wide persistent cancer disparities; compared to White people, mortality rates are two-fold higher for prostate, stomach and uterine corpus cancers in Black people and for liver, stomach, and kidney cancers in Native American people. Continued national progress will require increased investment in cancer prevention and access to equitable treatment, especially among American Indian and Alaska Native and Black individuals. |
No results stated in abstract. |
4 |
| 2. Farjah F, Monsell SE, Smith-Bindman R, et al. Fleischner Society Guideline Recommendations for Incidentally Detected Pulmonary Nodules and the Probability of Lung Cancer. J. Am. Coll. Radiol.. 19(11):1226-1235, 2022 Nov. |
Review/Other-Dx |
N/A |
The Fleischner Society aims to limit further evaluations of incidentally detected pulmonary nodules when the probability of lung cancer is <1% and to pursue further evaluations when the probability of lung cancer is =1%. To evaluate the internal consistency of guideline goals and recommendations, the authors evaluated stratum-specific recommendations and 2-year probabilities of lung cancer. |
No results stated in the abstract |
4 |
| 3. Sandler KL, Henry TS, Amini A, et al. ACR Appropriateness Criteria® Lung Cancer Screening: 2022 Update. J Am Coll Radiol 2023;20:S94-S101. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for lung cancer screening. |
No results stated in abstract. |
4 |
| 4. Mendoza DP, Petranovic M, Som A, et al. Lung-RADS Category 3 and 4 Nodules on Lung Cancer Screening in Clinical Practice. AJR Am J Roentgenol. 219(1):55-65, 2022 07. |
Review/Other-Dx |
1,139 patients (598 male, 541 female) |
The purpose of this study was to assess the frequency of cancer among lung nodules assigned Lung-RADS category 3 or 4 at lung cancer screening (LCS) in clinical practice and to evaluate factors that affect the cancer frequency within each category. |
Of the 9148 LCS examinations, 857 (9.4%) were assigned Lung-RADS category 3, and 721 (7.9%) were assigned category 4. The final analysis included 1297 unique nodules in 1139 patients (598 men, 541 women; mean age, 66.0 ± 6.3 years). A total of 1108 of 1297 (85.4%) nodules were deemed benign, and 189 of 1297 (14.6%) were deemed malignant. The frequencies of malignancy of category 3, 4A, 4B, and 4X nodules were 3.9%, 15.5%, 36.3%, and 76.8%. A total of 45 of 46 (97.8%) endobronchial nodules (all category 4A) were deemed benign on the basis of resolution. Cancer frequency was 13.1% for solid, 24.4% for part-solid, and 13.5% for ground-glass nodules. |
4 |
| 5. Takeuchi Y, Shinagawa N, Kikuchi E, et al. The predictive value of endobronchial ultrasonography with a guide sheath in the diagnosis of the histologic subtypes of lung cancer. Respir Investig. 54(6):473-478, 2016 Nov. |
Observational-Dx |
203 patients |
To evaluate the consistency between the types of lung cancer histologically diagnosed by bronchial biopsy or cytologically by EBUS-GS, and the final diagnosis of the resected specimen. |
Of the 40 cases diagnosed as Sq by EBUS-GS, 37 cases were diagnosed as Sq, and 3 cases were diagnosed as non-Sq after surgical resection. Of the 159 cases diagnosed as non-Sq by EBUS-GS, 151 cases were diagnosed as non-Sq, 6 as Sq, and 2 as small cell carcinoma after surgical resection. These results showed that the positive predictive value of EBUS-GS in the diagnosis of Sq was 93%, and its positive predictive value in diagnosing non-Sq was 95%. |
2 |
| 6. Eom JS, Mok JH, Kim I, et al. Radial probe endobronchial ultrasound using a guide sheath for peripheral lung lesions in beginners. BMC polm. med.. 18(1):137, 2018 Aug 13. |
Review/Other-Dx |
200 patients |
To assess the diagnostic yields, learning curve, and safety profile of EBUS-GS performed by these inexperienced physicians, the first 100 consecutive EBUS-GS procedures were included in the evaluation. |
The overall diagnostic yield of EBUS-GS performed by two physicans in 200 patients with a peripheral lung lesion was 73.0%. Learning curve analyses showed that the diagnostic yields were stable, even when the procedure was performed by beginners. Complications related to EBUS-GS occurred in three patients (1.5%): pneumothorax developed in two patients (1%) and resolved spontaneously without chest tube drainage; another patient (0.5%) developed a pulmonary infection after EBUS-GS. There were no cases of pneumothorax requiring chest tube drainage, severe hemorrhage, respiratory failure, premature termination of the procedure, or procedure-related mortality. |
4 |
| 7. Nadig TR, Thomas N, Nietert PJ, et al. Guided Bronchoscopy for the Evaluation of Pulmonary Lesions: An Updated Meta-analysis. Chest 2023;163:1589-98. |
Meta-analysis |
16,389 lesions from 126 studies |
Has the diagnostic yield of guided bronchoscopy in patients with PPLs improved over the past decade? |
A total of 16,389 lesions from 126 studies were included. There was no significant difference in diagnostic yield prior to 2012 (39 studies; 3,052 lesions; yield 70.5%) vs after 2012 (87 studies; 13,535 lesions; yield 69.2%) (P > .05). Additionally, there was no significant difference in yield when comparing different technologies. Studies with low risk of overall bias had a lower diagnostic yield than those with high risk of bias (66% vs 71%, respectively; P = .018). Lesion size > 2 cm, presence of bronchus sign, and reports with a high prevalence of malignancy in the study population were associated with significantly higher diagnostic yield. Significant (P < .0001) between-study heterogeneity was also noted. |
Good |
| 8. Kang N, Shin SH, Yoo H, et al. Infectious complications of EBUS-TBNA: A nested case-control study using 10-year registry data. Lung Cancer 2021;161:1-8. |
Experimental-Dx |
6826 patients |
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become a standard procedure, but little is known about its infectious complications. The aim of this study is to evaluate the incidence and risk factors of infectious complications of EBUS-TBNA and its clinical course, including effects on anti-cancer treatment. |
Of the 6826 patients, 33 (0.48%) infectious complications were identified, comprising pneumonia (n = 20) and mediastinal infections (n = 13). Target lesions with necrotic features on chest computed tomography (CT) scan (adjusted odds ratio [aOR], 3.08; 95% confidence interval [CI], 1.49-6.40; P = 0.002) and procedures that were performed via the esophagus (aOR, 3.19; 95% CI, 1.47-6.88; P = 0.003) were independently associated with infectious complications. Among patients ultimately diagnosed with cancer, the infection group tended to refuse anti-cancer treatment compared to controls (32/459, 7.0% vs. 5/30, 16.7%; P = 0.066). However, among the patients who received anti-cancer treatment, there was no delay in onset of treatment. |
2 |
| 9. Fu YF, Zhang JH, Wang T, Shi YB. Endobronchial ultrasound-guided versus computed tomography-guided biopsy for peripheral pulmonary lesions: A meta-analysis. Clin Respir J 2021;15:3-10. |
Meta-analysis |
2025 |
Both endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) and computed tomography-guided transthoracic needle biopsy (CT-TTNB) are approaches commonly utilized to diagnose peripheral pulmonary lesions (PPLs). The present meta-analysis was, therefore, designed to provide more reliable evidence regarding the relative advantages of these two approaches to PPL diagnosis in order to guide clinical decision making. |
When diagnosing PPLs, CT-TTNB is associated with higher diagnostic yield and accuracy but with poorer safety outcomes than EBUS-TBB. |
Good |
| 10. Chowdhry VK, Chowdhry AK, Goldman N, Scalzetti EM, Grage RA, Bogart JA. Complications from computed tomography-guided core needle biopsy for patients receiving stereotactic body radiation therapy for early-stage lesions of the lung. CLIN LUNG CANCER. 15(4):302-6, 2014 Jul. |
Observational-Tx |
103 patients |
The purpose of this series is to identify patients who underwent stereotactic body radiation therapy (SBRT) and review the complications of biopsy performed before treatment. |
A total of 112 percutaneous biopsies were performed in 103 patients. Pneumothorax of any degree was observed in 40 patients (35%) (95% CI, 27%-45%), and 12 patients (10.7%) had a clinically significant pneumothorax requiring chest tube placement (95% CI, 6%-18%). The time to first fraction of SBRT was not different in patients who had a pneumothorax or placement of a chest tube. On multivariate analysis, age, performance status, smoking history, pack-years of smoking, chronic obstructive pulmonary disease history, and forced expiratory volume in the first second of expiration were not statistically significantly associated with chest tube placement. |
2 |
| 11. Maxwell AW, Klein JS, Dantey K, Mount SL, Butnor KJ, Leiman G. CT-guided transthoracic needle aspiration biopsy of subsolid lung lesions. J Vasc Interv Radiol. 25(3):340-6, 346.e1, 2014 Mar. |
Observational-Dx |
32 patients |
To assess the diagnostic performance of computed tomography (CT)-guided transthoracic needle aspiration biopsy (TNAB) in the evaluation of persistent subsolid lung lesions. |
In 32 patients, a diagnosis of benign or malignant disease was identified through evaluation of pathologic or follow-up data. There were 18 men and 14 women, with a mean age of 67.1 years ± 9.6 (range, 52-86 y). The mean lesion diameter was 21 mm ± 11 (range, 8-62 mm). A final diagnosis of malignancy was made in 28 cases (87.5%); four benign lesions were also diagnosed. The overall sensitivity of CT-guided TNAB in the evaluation of these lesions was 89.2%, and the specificity and positive predictive value were 100%. Two pneumothoraces (6.3%) were identified. |
3 |
| 12. Sargent T, Kolderman N, Nair GB, Jankowski M, Al-Katib S. Risk Factors for Pneumothorax Development Following CT-Guided Core Lung Nodule Biopsy. J Bronchology Interv Pulmonol. 29(3):198-205, 2022 Jul 01. |
Review/Other-Dx |
671 |
This study aims to correlate nodule, patient, and technical risk factors less commonly investigated in the literature with pneumothorax development during computed tomography-guided core needle lung nodule biopsy. |
The overall incidence of pneumothorax was 26.7% (n=179). Risk factors identified on univariate analysis include anterior [odds ratio (OR)=1.98; P<0.001] and lateral (OR=2.17; P=0.002) pleural surface puncture relative to posterior puncture, traversing more than one pleural surface with the biopsy needle (OR=2.35; P=0.06), patient positioning in supine (OR=2.01; P<0.001) and decubitus nodule side up (OR=2.54; P=0.001) orientation relative to decubitus nodule side down positioning, and presence of emphysema in the path of the biopsy needle (OR=3.32; P<0.001). In the multivariable analysis, the presence of emphysematous parenchyma in the path of the biopsy needle was correlated most strongly with increased odds of pneumothorax development (OR=3.03; P=0.0004). Increased body mass index (OR=0.95; P=0.001) and larger nodule width (cm; OR=0.74; P=0.02) were protective factors most strongly correlated with decreased odds of pneumothorax development. |
4 |
| 13. Aktas AR, Gozlek E, Yilmaz O, et al. CT-guided transthoracic biopsy: histopathologic results and complication rates. Diagn Interv Radiol. 21(1):67-70, 2015 Jan-Feb. |
Observational-Dx |
85 |
We aimed to investigate the effectiveness and complications of transthoracic CT-guided biopsy techniques |
Diagnostic results were achieved in 79 of 94 biopsy procedures. Pathology results were malignant in 54 patients, suspicious for malignancy in three patients, benign in five patients, and benign nonspecific in 17 patients. Specific diagnoses were obtained in 59 patients (62.8%) using core biopsy, but no specific diagnosis could be reached with transthoracic fine-needle aspiration biopsy. Complications included pneumothorax in 27 patients (28.7%) and parenchymal hemorrhage during and after the procedure in eight patients (8.5%). |
3 |
| 14. Rodrigues JCL, Pierre AF, Hanneman K, et al. CT-guided Microcoil Pulmonary Nodule Localization prior to Video-assisted Thoracoscopic Surgery: Diagnostic Utility and Recurrence-Free Survival. Radiology. 291(1):214-222, 2019 04. |
Observational-Dx |
124 |
To assess the diagnostic utility and recurrence-free survival over a minimum of 2 years following CT-guided microcoil localization and VATS. |
In 124 patients (men, 35%; mean age, 65 years ± 12) with a nodule found at CT, microcoil localization and VATS resection were performed for a total of 126 nodules (mean size, 13 mm ± 6; mean distance to pleura, 20 mm ± 9). On presurgical CT evaluation, 42% (53 of 126) of nodules were solid, 33% (41 of 126) were ground glass, and 24% (30 of 126) were subsolid. VATS excisional biopsy altered cytopathologic diagnosis in 21% (five of 24) of patients with prior diagnostic premicrocoil CT-guided biopsy. At histopathologic examination, 17% (21 of 126) of the nodules were adenocarcinoma in situ, 17% (22 of 126) were minimally invasive adenocarcinoma, 30% (38 of 126) were invasive lung primary tumors, and 22% (28 of 126) were metastases. Among the 72 patients with malignancy at histopathologic examination and at least 2 years of CT surveillance, local recurrence occurred in 7% (five of 72), intrathoracic recurrence in 22% (16 of 72), and extrathoracic recurrence in 18% (13 of 72) after 2 or more years of CT surveillance. There was no recurrence for adenocarcinoma in situ, minimally invasive adenocarcinoma, or invasive lung tumors measuring less than 1 cm. After multivariable adjustment, nodule location at a distance greater than 10 mm from the pleura was an independent predictor of time to recurrence (hazard ratio, 2.9 [95% confidence interval: 1.1, 7.4]; P = .03). |
3 |
| 15. Rostambeigi N, Scanlon P, Flanagan S, et al. CT Fluoroscopic-Guided Coil Localization of Lung Nodules prior to Video-Assisted Thoracoscopic Surgical Resection Reduces Complications Compared to Hook Wire Localization. J Vasc Interv Radiol. 30(3):453-459, 2019 03. |
Observational-Tx |
46 patients (29 males) |
To compare the safety and efficacy of hook wire versus microcoil localization of pulmonary nodules prior to video-assisted thoracoscopic resection (VATS). |
Successful resection of nodules was achieved in all patients. Twelve cases of displacement of the hook wire were observed compared to only 1 in the coil group (P < .01). The total complication rate was lower in the coil group (25% vs 54%, P = .04). Two patients required transition to thoracotomy in the hook wire group, compared to none in the coil group. Median blood loss was similar in both groups (median loss, 20-22 mL). One patient had positive margins in the hook wire group. There was a nonsignificant trend toward longer hospital stay and higher major complication rates after hook wire localization (P = .4). |
2 |
| 16. Gungor S, Gunaydin UM, Yakar HI, Simsek ET, Akbiyik AG, Keskin H. Total Lesion Glycolysis Obtained by FDG PET/CT in Diagnosing Solitary Pulmonary Nodules. J Coll Physicians Surg Pak 2023;33:27-31. |
Observational-Dx |
80 patients (56 males, 24 females) |
To evaluate the diagnostic performance of total lesion glycolysis (TLG) obtained by 18F-FDG PET/ CT to differentiate malignant solitary pulmonary nodules (SPNs) from benign ones. |
The number of the detected benign and malignant SPNs was 38 and 42, respectively. Compared to the benign lesions, the malignant nodules presented significantly higher values in terms of SUVmax, TLG, and the volumes of metabolic tumour (MTV) and CT. Considering all parameters, the highest area under the curve (AUC) was occupied by TLG and SUVmax. The values for the sensitivity, specificity, and accuracy of SUVmax, TLG, and SUVmax combined with TLG were as follows respectively: 97.6%, 63.2%, and 81.2%; 85.7%, 92.1%, and 88.7%; and 85.7%, 94.7%, and 90%. |
3 |
| 17. Christensen J, Prosper AE, Wu CC, et al. ACR Lung-RADS v2022: Assessment Categories and Management Recommendations. J Am Coll Radiol 2023. |
Review/Other-Dx |
N/A |
To summarize the current evidence and expert consensus supporting Lung-RADS v2022 by the ACR Lung-RADS Committee. |
No results stated in the abstract. |
4 |
| 18. Higuchi M, Honjo H, Shigihara T, Shishido F, Suzuki H, Gotoh M. A phase II study of radiofrequency ablation therapy for thoracic malignancies with evaluation by FDG-PET. J Cancer Res Clin Oncol. 140(11):1957-63, 2014 Nov. |
Experimental-Dx |
27 |
Computed tomography (CT)-guided radiofrequency ablation (RFA) is safe and effective for patients with unresectable primary, recurrent, or metastatic thoracic malignancies. Several studies have shown the benefit of employing 18-fluoro-deoxyglucose positron-emission tomography (FDG-PET) to follow thoracic malignancies treated with RFA. In this prospective study, we show the safety and therapeutic efficacy of RFA and the utility of FDG-PET as tool for early detection of local recurrence. |
There were 17 adverse events (70.8 %) in 24 ablations included 13 pneumothoraces, two cases of chest pain, and two episodes of fever. With a median follow-up of 35.9 months (range 1-62 months), the overall 2-year survival rate was 84.2 %. Local recurrence occurred at four sites (2-year local control rate was 74.3 %). The FDG-PET results 7-14 days after RFA did not predict recurrence, whereas positive findings 3-6 months after RFA significantly correlated with local recurrence (p = 0.0016). |
2 |
| 19. Ren Q, Zhou Y, Yan M, Zheng C, Zhou G, Xia X. Imaging-guided percutaneous transthoracic needle biopsy of nodules in the lung base: fluoroscopy CT versus cone-beam CT. Clin Radiol. 77(5):e394-e399, 2022 05. |
Observational-Dx |
379 |
To compare the diagnostic performance and safety of fluoroscopy computed tomography (FCT)-guided to cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) in patients with nodules in the lung base. |
PTNB technical success rates were 98.2% in the FCT group and 98.7% in the CBCT group (p=0.548). For larger lesions (>2 cm in diameter), PTNBs under FCT had similar diagnostic accuracy (95.5% versus 93.64%), incidence of pneumothorax (31.5% versus 21.3%) and radiation exposure (16.8 ± 6.1 versus 15.2 ± 4 mSv) compared to those under CBCT guidance. For smaller lesions (=2 cm in diameter), the diagnostic accuracy was similar (92.86% versus 100%), but there was a higher incidence of pneumothorax (66.7% versus 31%, p=0.030) and more radiation exposure (19.9 ± 8.4 versus 15.3 ± 5 mSv, p=0.040) under FCT guidance than CBCT. |
3 |
| 20. Grange R, Sarkissian R, Bayle-Bleuez S, et al. Preventive tract embolization with gelatin sponge slurry is safe and considerably reduces pneumothorax after CT-guided lung biopsy with use of large 16-18 coaxial needles. Br J Radiol. 95(1133):20210869, 2022 May 01. |
Observational-Dx |
100 |
To evaluate the clinical impact of the tract embolization technique using gelatin sponge slurry after percutaneous CT-guided lung biopsy |
Patients with gelatin sponge slurry tract embolization had statistically lower rates of pneumothorax ((17.1% vs 39%, p < 0.001). In univariate analysis, tract embolization (OR = 0.32, CI = 0.17-0.61 p<0.001) and nodule size >2 cm (OR = 0.33 CI = 0.14-0.8 p = 0.013) had a protective effect on pneumothorax. The puncture path lengths > 2-20 mm and >20 mm were risk factors for pneumothorax (OR = 3.35 IC = 1.44-8.21 p = 0.006 and OR = 4.36 CI = 1.98-10.29 p<0.001, respectively). In multivariate regression analysis, tract embolization had a protective effect of pneumothorax (OR = 0.25, CI = 0.12-0.51, p < 0.001). The puncture path lengths > 2-20 mm and >20 mm were risk factors for pneumothorax (p = 0.030 and p = 0.002, respectively). |
2 |
| 21. Sum R, Lau T, Paul E, Lau K. Gelfoam slurry tract occlusion after computed tomography-guided percutaneous lung biopsy: Does it prevent major pneumothorax?. J Med Imaging Radiat Oncol. 65(6):678-685, 2021 Oct. |
Review/Other-Dx |
296 Patients |
To assess the efficacy of biopsy tract occlusion with a gelatin sponge slurry for preventing post-biopsy pneumothorax. |
Methods: Retrospective analysis was conducted on consecutive adult patients who underwent CT-guided lung biopsy over a 10-year period. Age, gender, existing chronic obstructive pulmonary disease (COPD), evidence of emphysema on CT, location of the lesion and the presence of pneumothorax on post-procedure CT and 4-h chest radiograph were recorded.Results: Two hundred and ninety-six patients were included (126 patients in the non-gelfoam group and 170 in the gelfoam group). When gelfoam was used, risk of developing an immediate pneumothorax was lower (P = 0.032). Patients with emphysema were 2.4 times more likely to develop a delayed pneumothorax without gelfoam (P = 0.034). There was a significantly higher risk of both immediate and delayed pneumothorax in non-peripheral lesions without gelfoam (P = 0.001 and P = 0.002, respectively). The frequency of requiring a chest tube to treat a pneumothorax was 86% lower when gelfoam was used (P = 0.012). |
4 |
| 22. Zlevor AM, Mauch SC, Knott EA, et al. Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies. J Vasc Interv Radiol. 32(9):1319-1327, 2021 09. |
Observational-Dx |
1,029 patients |
To evaluate the outcomes of computed tomography (CT) fluoroscopy-guided core lung biopsies with emphasis on diagnostic yield, complications, and efficacy of parenchymal and pleural blood patching to avoid chest tube placement. |
Methods: This is a single-center retrospective analysis of CT fluoroscopy-guided percutaneous core lung biopsies between 2006 and 2020. Parenchymal blood patching during introducer needle withdrawal was performed in 74% of cases as a preventive measure, and pleural blood patching was the primary salvage maneuver for symptomatic or growing pneumothorax in 60 of 83 (72.2%) applicable cases.Results: A total of 1,029 patients underwent 1,112 biopsies (532 men; mean age, 66 years; 38.6%, history of emphysema; lesion size, 16.7 mm). The diagnostic yield was 93.6% (1,032/1,103). Fewer complications requiring intervention were observed in patients who underwent parenchymal blood patching (5.7% vs 14.2%, P < .001). Further intervention was required in 83 of 182 pneumothorax cases, which included the following: (a) pleural blood patch (5.4%, 60/1,112), (b) chest tube placement without a pleural blood patch attempt (1.5%, 17/1,112), and (c) simple aspiration (0.5%, 6/1,112). Pleural blood patch as monotherapy was successful in 83.3% (50/60) of cases without need for further intervention. The overall chest tube rate was 2.6% (29/1,112). Emphysema was the only significant risk factor for complications requiring intervention (P = .001). |
3 |
| 23. Drumm O, Joyce EA, de Blacam C, et al. CT-guided Lung Biopsy: Effect of Biopsy-side Down Position on Pneumothorax and Chest Tube Placement. Radiology. 292(1):190-196, 2019 07. |
Review/Other-Dx |
373 patients |
To assess the effect of positioning patients biopsy side down during CT-guided lung biopsy on the incidence of pneumothorax, chest drain placement, and hemoptysis. |
Results A total of 373 consecutive patients (mean age ± standard deviation, 68 years ± 10), including 196 women and 177 men, were included in the study. Among these patients, 184 were positioned either prone or supine depending on the most direct path to the lesion and 189 were positioned biopsy side down. Pneumothorax occurred in 50 of 184 (27.2%) patients who were positioned either prone or supine and in 20 of 189 (10.6%) patients who were positioned biopsy side down (P < .001). Drain placement was required in 10 of 184 (5.4%) patients who were positioned either prone or supine and in eight of 189 (4.2%) patients who were positioned biopsy side down (P = .54). Hemoptysis occurred in 19 of 184 (10.3%) patients who were positioned prone or supine and in 10 of 189 (5.3%) patients who were positioned biopsy side down (P = .07). Prone or supine patient position (P = .001, odds ratio [OR] = 2.7 [95% confidence interval {CI}: 1.4, 4.9]), emphysema along the needle path (P = .02, OR = 2.1 [95% CI: 1.1, 4.0]), and lesion size (P = .02, OR = 1.0 [95% CI: 0.9, 1.0]) were independent risk factors for developing pneumothorax. |
4 |
| 24. De Filippo M, Saba L, Silva M, et al. CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?. Diagn Interv Radiol. 20(5):421-5, 2014 Sep-Oct. |
Review/Other-Dx |
538 patients |
To assess the correlation between pulmonary hemorrhage and pneumothorax in computed tomography (CT)-guided transthoracic fine needle aspiration (TTFNA), particularly its possible value as protection against the development of pneumotorax. |
Pneumothorax occurred in 154 cases (28.6%) and pulmonary hemorrhage occurred in 144 cases (26.8%). The incidence of pneumothorax was lower in patients showing type 1 and high-grade pulmonary hemorrhage pattern. The incidence of pneumothorax in biopsies =30 mm from pleural surface was 26% (12/46) in cases showing this pattern, while it was 71.4% (30/42) when this pattern was not seen. Similarly, the incidence of pneumothorax in biopsies <30 mm from the pleural surface was 0% (0/28) in cases showing this hemorrhage pattern, while it was 19% (76/394) when this pattern was not seen. |
4 |
| 25. Uhlig J, Ludwig JM, Goldberg SB, Chiang A, Blasberg JD, Kim HS. Survival Rates after Thermal Ablation versus Stereotactic Radiation Therapy for Stage 1 Non-Small Cell Lung Cancer: A National Cancer Database Study. Radiology. 289(3):862-870, 2018 12. |
Review/Other-Dx |
28,834 patients |
To compare survival rates of thermal ablation and stereotactic radiation therapy (SRT) for stage 1 non-small cell lung cancer (NSCLC). |
Patients treated with TA had more comorbidities (Charlson comorbidity index of 1 vs =2, 32.8% [362 of 1102] vs 19.7% [217 of 1102], respectively) compared with SRT (Charlson comorbidity index of 1 vs =2, 26.9% [7448 of 27 732] vs 15.3% [4251 of 27 732], respectively; P , .001) and smaller tumor size (mean tumor size, TA vs SRT: 19 mm vs 22 mm, respectively; P , .001). In the propensity score–matched cohort with balanced distribution of potential confounders, there was no significant difference in overall survival between TA and SRT at a mean follow-up of 52.4 months (survival difference, P = .69). Overall survival rates were comparable between TA and SRT (1 year, 85.4% vs 86.3%, respectively, P = .76; 2 years, 65.2% vs 64.5%, respectively, P = .43; 3 years, 47.8% vs 45.9%, respectively, P = .32; 5 years, 24.6% vs 26.1%, respectively, P = .81). Unplanned hospital readmission rates were higher for patients who underwent TA versus those who underwent SRT (3.7% [40 of 1070] vs 0.2% [two of 1070], respectively; P , .001). |
4 |
| 26. Miyahara N, Nii K, Benazzo A, et al. Solid predominant subtype in lung adenocarcinoma is related to poor prognosis after surgical resection: A systematic review and meta-analysis. Eur J Surg Oncol. 45(7):1156-1162, 2019 Jul. |
Meta-analysis |
12,137 LADC patients |
To evaluate the association between LADC subtype and survival. |
In total, 14 eligible studies including 12,137 LADC patients were identified, which assessed the impact of SP subtype on OS and DFS in patients treated with pulmonary resection. SP subtype was reported in 1246 (10.2%) patients and was associated with significantly worse OS (pooled HR, 1.51; 1.29-1.75) and DFS (pooled HR, 1.26; 1.14-1.40). |
Good |
| 27. Nasir BS, Yasufuku K, Liberman M. When Should Negative Endobronchial Ultrasonography Findings be Confirmed by a More Invasive Procedure?. Ann Surg Oncol. 25(1):68-75, 2018 Jan. |
Review/Other-Dx |
NA |
This article addresses the situations in which negative results should be confirmed by a more invasive procedure. |
No results listed in abstract. |
4 |
| 28. Lee KM, Lee G, Kim A, et al. Clinical outcomes of radial probe endobronchial ultrasound using a guide sheath for diagnosis of peripheral lung lesions in patients with pulmonary emphysema. Respir Res 2019;20:177. |
Review/Other-Tx |
393 |
This retrospective study was performed to identify the clinical outcomes of EBUS-GS in patients with pulmonary emphysema. This study included 393 consecutive patients who received EBUS-GS between February 2017 and April 2018. The patients were classified according to the severity of their emphysema, and factors possibly contributing to a successful EBUS-GS procedure were evaluated |
The overall diagnostic yield of EBUS-GS in patients with no or mild emphysema was significantly higher than in those with moderate or severe pulmonary emphysema (78% vs. 61%, P=0.007). There were no procedure related complications. The presence of a bronchus sign on CT (P < 0.001) and a “within the lesion” status on EBUS (P =0.009) were independently associated with a successful EBUS-GS procedure. Although the diagnostic yield of EBUS-GS in patients with moderate-to-severe emphysema was relatively low, a bronchus sign and “within the lesion” status on EBUS were contributing factors for a successful EBUS-GS |
4 |
| 29. Bowling MR, Folch EE, Khandhar SJ, et al. Fiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE study. Therap. adv. respir. dis.. 13:1753466619841234, 2019 Jan-Dec. |
Observational-Tx |
258 |
NAVIGATE is a global, prospective, multicenter, observational cohort study of ENB using the super Dimension™ navigation system. This prospectively collected subgroup analysis presents the patient demographics, procedural characteristics, and 1-month outcomes in patients undergoing ENB-guided FM placement. Follow up through 24 months is ongoing. |
Two-hundred fifty-eight patients from 21 centers in the United States were included. General anesthesia was used in 68.2%. Lesion location was confirmed by radial endobronchial ultrasound in 34.5% of procedures. The median ENB procedure time was 31.0 min. Concurrent lung lesion biopsy was conducted in 82.6% (213/258) of patients. A mean of 2.2 ± 1.7 FMs (median 1.0 FMs) were placed per patient and 99.2% were accurately positioned based on subjective operator assessment. Follow-up imaging showed that 94.1% (239/254) of markers remained in place. The procedure-related pneumothorax rate was 5.4% (14/258) overall and 3.1% (8/258) grade ? 2 based on the Common Terminology Criteria for Adverse Events scale. The procedure-related grade ? 4 respiratory failure rate was 1.6% (4/258). There were no bronchopulmonary hemorrhages. |
2 |
| 30. Moran DE, Parikh M, Sheiman RG, et al. Comparison of technical success and safety of transbronchial versus percutaneous CT-guided fiducial placement for SBRT of lung tumors. J Med Imaging Radiat Sci 2021;52:409-16. |
Observational-Dx |
242 patients |
To evaluate the technical success and safety of transbronchial (bronchoscopic) fiducial placement compared to percutaneous CT-guided fiducial placement for stereotactic body radiotherapy (SBRT) of lung tumors. |
Two hundred and forty-four patients with lung tumors and 272 fiducial seed placements were included in the study. Two hundred and twenty-one of the 272 (81.2%) fiducial markers were placed percutaneously and 51/272 (18.8%) were placed transbronchially. Pneumothorax was seen in 73/221 (33%) of percutaneously-placed fiducials and in 4/51 (7.8%) of transbronchial placements (p<0.001). No significant difference was seen in the rate of chest tube placement between the two groups: 20/221 (9%) of percutaneously placed fiducials and 2/51 (3.9%) of transbronchially placed fiducials (p=0.39). Fifteen of the 51 (29%) of fiducial placements with transbronchial approach were unsuccessful, as discovered at radiotherapy planning session, and required a repeat procedure. Nine of the 15 (60%) of repeat procedures were performed percutaneously, 5/15 (33%) were placed during repeat bronchoscopy, and 1/15 (7%) was placed at transesophageal endoscopic ultrasound. No repeat fiducial placements were required for patients who had the fiducials placed percutaneously (p<0.001), with a technical success rate of 100%. |
3 |
| 31. Hanauer M, Perentes JY, Krueger T, et al. Pre-operative localization of solitary pulmonary nodules with computed tomography-guided hook wire: report of 181 patients. J Cardiothorac Surg 2016;11:5. |
Review/Other-Dx |
181 patients |
The aim of the study was to report the utility and the results of pre-operative computed tomography (CT)-guided hook wire localization of solitary pulmonary nodules (SPN). |
One hundred eighty-one patients (90 females, mean age 63 y, range 28-82 y) underwent 187 pulmonary resections after CT-guided hook wire localization. The mean SPN diameter was 10.3 mm (range: 4-29 mm). The mean distance of the lesion from the pleural surface was 11.6 mm (range: 0-45 mm). The mean time interval from hook wire insertion to VATS resection was 224 min (range 54-622 min). Hook wire complications included pneumothorax requiring chest tube drainage in 4 patients (2.1%) and mild parenchymal haemorrhage in 11 (5.9%) patients. Migration of the hook wire occurred in 7 patients (3.7%) although it did not affect the success of VATS resection (nodule location guided by the lung puncture site). Three patients underwent additional wedge resection by VATS during the same procedure because no lesion was identified in the surgical specimen. Conversion thoracotomy was required in 13 patients (7 %) for centrally localized lesions (6 patients) and pleural adhesions (7 patients). The mean operative time was 60 min (range 18-135 min). Pathological examination revealed a malignant lesion in 107 patients (59 %). The diagnostic yield was 98.3 %. |
4 |
| 32. Mendogni P, Daffre E, Rosso L, et al. Percutaneous lung microwave ablation versus lung resection in high-risk patients. A monocentric experience. Acta Biomed Ateneo Parmense. 91(10-S):e2020002, 2020 09 23. |
Experimental-Tx |
67 |
The aim of our study is to compare MWA and pulmonary lobectomy in high-risk, lung cancer patients. |
32 patients underwent MWA, and 35 high-risk patients submitted to lung lobectomy in the same period were selected. Median follow-up time was 51.1 months (95% CI: 43.8-62.3). Overall survival was 43.8 (95% CI: 26.1-55) and 55.8 months (95% CI: 49.9-76.8) in the MWA group and Lobectomy group, respectively. Our study demonstrated a high percentage of local relapse in the MWA group but a comparable overall survival. |
2 |
| 33. Han X, Wei Z, Zhao Z, Yang X, Ye X. Cost and effectiveness of microwave ablation versus video-assisted thoracoscopic surgical resection for ground-glass nodule lung adenocarcinoma. Front. oncol.. 12:962630, 2022. |
Observational-Tx |
204 |
To retrospectively evaluate the cost and effectiveness in consecutive patients with ground-glass nodules (GGNs) treated with video-assisted thoracoscopic surgery (VATS; i.e., wedge resection or segmentectomy) or microwave ablation (MWA). |
The rates of 3-year OS, LPFS, and CSS were 100%, 98.9%, and 100%, respectively, in the VATS group and 100%, 100% (p = 0.423), and 100%, respectively, in the MWA group. The median cost of VATS vs. MWA was RMB 54,314.36 vs. RMB 21,464.98 (p < 0.001). The length of hospital stay in the VATS vs. MWA group was 10.0 vs. 6.0 d (p < 0.001). |
3 |
| 34. Tan C, Fisher OM, Huang L, et al. Comparison of Microwave and Radiofrequency Ablation in the Treatment of Pulmonary Metastasis of Colorectal Cancer. Anticancer Res. 42(9):4563-4571, 2022 Sep. |
Observational-Tx |
203 patients |
The purpose of this study was to evaluate and compare the effectiveness in treatment including short-term outcome as well as local tumour control, time to tumour progression, and survival rates among patients with pulmonary metastatic colorectal cancer who undergo radiofrequency ablation (RFA) or microwave ablation (MWA). |
A total of 161 patients underwent RFA and 42 MWA. Median ablation size and time was 4 (range=3-5 cm) vs. 3.5 cm (range=3-4 cm; p=0.0395) and 49 (range=26-65 min) vs. 8 min (5-13 min) in the RFA and MWA groups, respectively (p<0.001). The complication rate was 112 (55%) and 40 (74%) in the RFA and MWA group, respectively (p=0.011). Life-threatening pulmonary haemorrhage occurred in 1 (0.5%) and 4 (7.4%) patients in the RFA and MWA group, respectively (p=0.007). Local recurrences detected after discharge were similar in both groups [28% (p<0.001)]. However, the MWA group demonstrated higher survival rate and less recurrence rate than RFA in the first 24 months of follow up. |
2 |
| 35. Palussiere J, Chomy F, Savina M, et al. Radiofrequency ablation of stage IA non-small cell lung cancer in patients ineligible for surgery: results of a prospective multicenter phase II trial. J Cardiothorac Surg. 13(1):91, 2018 Aug 24. |
Experimental-Tx |
32 |
The main objective was to evaluate the local control of RFA at 1 year. Secondary objectives were to estimate the overall survival (OS) at one and 3 years, local control at 3 years, lung function and quality of life (QoL) after RFA. |
Twenty-seven patients did not recur at 1 year corresponding to a local control rate of 84.38% (95% CI, [67.21-95.72]). The local control rate at 3 years was 81.25% (95% CI, [54.35-95.95]). The OS rate was 91.67% (95% CI, [77.53-98.25]) at 1 year and 58.33% (95% CI, [40.76-74.49]) at 3 years. The forced expiratory volume was stable in most patients apart from two, in whom we observed a 10% decrease. There was no significant change in the global health status or in the quality of life following RFA. |
2 |
| 36. Bourgouin PP, Wrobel MM, Mercaldo ND, et al. Comparison of Percutaneous Image-Guided Microwave Ablation and Cryoablation for Sarcoma Lung Metastases: A 10-Year Experience. AJR Am J Roentgenol. 218(3):494-504, 2022 03. |
Review/Other-Dx |
27 patients |
To compare technical success, complications, local tumor control, and overall survival (OS) after MWA versus cryoablation of sarcoma lung metastases. |
METHODS. This retrospective cohort study included 27 patients (16 women, 11 men; median age, 64 years; Eastern Cooperative Oncology Group performance score, 0-2) who, from 2009 to 2021, underwent 39 percutaneous CT-guided ablation sessions (21 MWA and 18 cryoablation sessions; one to four sessions per patient) to treat 65 sarcoma lung metastases (median number of tumors per patient, one [range, one to 12]; median tumor diameter, 11.0 mm [range, 5-33 mm]; 25% of tumors were nonperipheral). We compared complications according to ablation modality by use of generalized estimating equations. We evaluated ablation modality, tumor size, and location (peripheral vs nonperipheral) in relation to local tumor progression by use of proportional Cox hazard models, with death as the competing risk. We estimated OS using the Kaplan-Meier method. RESULTS. Primary technical success was 97% for both modalities. Median follow-up was 23 months (range, one to 102 months; interquartile range, 12-44 months). A total of seven of 61 tumors (11%) showed local progression. Estimated 1-year and 2-year local control rates were, for tumors 1 cm or smaller, 97% and 95% after MWA versus 99% and 98% after cryoablation, and for tumors larger than 1 cm, 74% and 62% after MWA versus 86% and 79% after cryoablation. Tumor size of 1 cm or smaller was associated with a decreased cumulative incidence of local progression (p = .048); ablation modality and tumor location were not associated with progression (p = .86 and p = .54, respectively). Complications (Common Terminology Criteria for Adverse Events [CTCAE] grade, = 3) occurred in 17 of 39 sessions (44%), prompting chest tube placement in nine (23%). There were no CTCAE grade 4 or 5 complications. OS at 1, 2, and 3 years was 100%, 89%, and 82%, respectively. |
4 |
| 37. He C, Zhao L, Yu HL, et al. Incidence and risk factors for pulmonary hemorrhage after percutaneous CT-guided pulmonary nodule biopsy: an observational study. Sci Rep 2024;14:7348. |
Observational-Dx |
593 |
To evaluate the current incidence of pulmonary hemorrhage and the potential factors contributing to its increased risk after percutaneous CT-guided pulmonary nodule biopsy and to summarize the technical recommendations for its treatment. |
A total of 593 patients were included in this study (Table 1), 31.7% (188/593) of whom were outpatients and 13.8% (82/593) of the patients underwent percutaneous puncture biopsy after a multidisciplinary team (MDT) consultation was conducted. The procedure was performed in 97.1% (576/593) of patients in a state of free breathing. Eighteen percent (107/593) of patients performed breathing exercises before PCPNB. Patients with diabetes accounted for 10.6% (64/593), and 39.5% (234/593) of patients had hypertension (140/90 mmHg). The incidences of pulmonary hemorrhage were as follows: grade 0, 36.1% (214/593); grade 1, 36.8% (218/593); grade 2, 18.9% (112/593); grade 3, 3.5% (21/593); and grade 4, 4.7% (28/593). HGH occurred in 27.2% (161/593) of the patients. Hemoptysis occurred in 2.8% (17/593) of the patients after biopsy, and the median hemoptysis volume was 10 mL (IQR 3.5, 100). However, only 6.5% (39/593) of the patients with hemorrhage underwent medical intervention. Air embolism, a rare complication, occurred in 0.2% (1/593) of the patients in the HGH group. Hemothorax occurred in 0.35% (21/593) of the patients who underwent biopsy. Univariate analysis of patients with high-grade hemorrhage Univariate analysis (Table 1) demonstrated that the occurrence of high-grade hemorrhage was significantly associated with location (p?=?0.022), breathing exercises (p?=?0.000), contrast-enhanced CT (p?=?0.008), number of pleural passes (p?=?0.012), puncture length (p?=?0.007), needle size (p?=?0.000), coaxial technique (p?=?0.000), prophylactic medication for hemostasis (p?=?0.000), and the number of cuttings (p?=?0.000). Other patient-, lesion-, and technique-related variables were not significantly associated with the occurrence of HGH. Based on past procedures and previous literature results9,12,14,17, the potential risk factors for pulmonary hemorrhage were as follows: prolonged operation time (p?=?0.059), nodule size (p?=?0.307), CTR?>?50% (p?=?0.293), involvement of the upper lobe (p?=?0.652), surgical position (p?=?0.926), CT reconstruction (p?=?0.878), use of semiautomatic needles (p?=?0.383), mPAD?>?29 mm (p?=?0.433), and emphysema (p?=?0.202). Multivariate analysis of high-grade hemorrhage The multivariable logistic regression results are shown in Fig. 2. Breathing exercises (HR 0.214, 95% CI 0.095–0.479), use of semiautomatic needles (HR 0.291, 95% CI 0.126–0.674), coaxial technique (HR 0.080, 95% CI 0.038–0.165), and ICECT (HR 0.486, 95% CI 0.263–0.895) were protective factors for HGH, respectively. The risk of HGH was significantly increased in patients with a mPAD?>?29 mm (HR 1.890, 95% CI 1.134–3.149), a greater puncture length (HR 1.150, 95% CI 1.021–1.295), hilar nodules (HR 4.579, 95% CI 1.930–10.863), intermediate nodules (HR 1.971, 95% CI 1.087–3.574), or a small nodule size (HR 0.635, 95% CI 0.442–0.914). Other variables were not significantly associated with the occurrence of HGH. These factors had clinical value in predicting HGH, with an AUC of 0.783 (95% CI 0.737–0.829) (Fig. 3). |
3 |
| 38. Uhlig J, Mehta S, Case MD, et al. Effectiveness of Thermal Ablation and Stereotactic Radiotherapy Based on Stage I Lung Cancer Histology. J Vasc Interv Radiol. 32(7):1022-1028.e4, 2021 07. |
Observational-Tx |
28,425 |
To assess whether the effectiveness of thermal ablation (TA) and stereotactic body radiotherapy (SBRT) as initial treatments for stage I lung cancer varies depending on the histological subtype. |
A total of 28,425 patients were included (SBRT, n = 27,478; TA, n = 947). TA was more likely to be used in Caucasian patients, those with more comorbidities and smaller neuroendocrine tumors (NETs) of the lower lobe, and those whose treatment had taken place in the northeastern United States. After propensity score matching, a cohort with 4,085 SBRT and 817 TA patients with balanced confounders was obtained. In this cohort, OS for TA and SBRT was comparable (hazard ratio = 1.07; 95% confidence interval,0.98-1.18; P = .13), although it varied by histological subtypes: higher OS for TA was observed in patients with non-small cell NETs (vs SBRT hazard ratio = 0.48; 95% confidence interval, 0.24-0.95; P = .04). No significant OS differences between TA and SBRT were noted for adenocarcinomas, squamous cell carcinomas, small cell carcinomas, and non-neuroendocrine large cell carcinomas (each, P > .1). |
2 |
| 39. Timmerman RD, Paulus R, Pass HI, et al. Stereotactic Body Radiation Therapy for Operable Early-Stage Lung Cancer: Findings From the NRG Oncology RTOG 0618 Trial. JAMA Oncol. 4(9):1263-1266, 2018 09 01. |
Observational-Tx |
26 patients |
To evaluate whether noninvasive stereotactic body radiation therapy (SBRT) delivered on an outpatient basis can safely eradicate lung cancer and cure selected patients with operable lung cancer, obviating the need for surgical resection. |
Of 33 patients accrued, 26 were evaluable (23 T1 and 3 T2 tumors; 15 [58%] male; median age, 72.5 [range, 54-88] years). Median FEV1 and diffusing capacity of the lung for carbon monoxide at enrollment were 72.5% (range, 38%-136%) and 68% (range, 22%-96%) of predicted, respectively. Only 1 patient had a primary tumor recurrence. Involved lobe failure, the other component defining local failure, did not occur in any patient, so the estimated 4-year primary tumor control and local control rate were both 96% (95% CI, 83%-100%). As per protocol guidelines, the single patient with local recurrence underwent salvage lobectomy 1.2 years after SBRT, complicated by a grade 4 cardiac arrhythmia. The 4-year estimates of disease-free and overall survival were 57% (95% CI, 36%-74%) and 56% (95% CI, 35%-73%), respectively. Median overall survival was 55.2 months (95% CI, 37.7 months to not reached). Protocol-specified treatment-related grade 3, 4, and 5 adverse events were reported in 2 (8%; 95% CI, 0.1%-25%), 0, and 0 patients, respectively. |
2 |
| 40. Mulvihill MS, Cox ML, Becerra DC, et al. Higher Use of Surgery Confers Superior Survival in Stage I Non-Small Cell Lung Cancer. Ann Thorac Surg. 106(5):1533-1540, 2018 11. |
Review/Other-Dx |
139,802 |
Lobar resection is the gold standard therapy for medically fit patients with stage I non-small cell lung cancer (NSCLC). However, considerable variability exists in the use of surgical therapy. This study tested the hypothesis that center-based variation in the use of surgical therapy affects survival in NSCLC. |
A total of 139,802 patients met the criteria. There was wide variation in the per-center rate of surgical resection in the highest (80.8%) versus lowest (41.4%, p < 0.001) quartile. Across cohorts, patients were similar in age (mean 68.8 years in the highest quartile versus 69.7 in the lowest quartile) and Charlson-Deyo Score of 2 or greater (15.1% in the highest quartile versus 14.4% in the lowest quartile). Five-year survival was higher for patients treated at high-use centers (52.7% versus 36.7%, p < 0.001). After adjustment, an adjusted rate of surgical therapy in the lowest 25th percentile was associated with lower survival (adjusted hazard ratio 1.40, 95% confidence interval: 1.37 to 1.40, p < 0.001). |
4 |
| 41. Altorki N, Wang X, Damman B, et al. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). The Journal of thoracic and cardiovascular surgery 2024;167:338-47 e1. |
Observational-Tx |
697 patients |
We report differences in disease-free survival (DFS), overall survival (OS) and lung cancer-specific survival (LCSS) between LR, segmental resection (SR), and wedge resection (WR). We also report differences between WR and SR in terms of surgical margins, rate of locoregional recurrence (LRR), and expiratory flow rate at 6 months postoperatively. |
A total of 362 patients had LR, 131 had SR, and 204 had WR. Basic demographic and clinical and pathologic characteristics were similar in the 3 groups. Five-year DFS was 64.7% after LR (95% confidence interval [CI], 59.6%-70.1%), 63.8% after SR (95% CI, 55.6%-73.2%), and 62.5% after WR (95% CI, 55.8%-69.9%) (P = .888, log-rank test). Five-year OS was 78.7% after LR, 81.9% after SR, and 79.7% after WR (P = .873, log-rank test). Five-year LCSS was 86.8% after LR, 89.2% after SR, and 89.7% after WR (P = .903, log-rank test). LRR occurred in 12% after SR and in 14% after WR (P = .295). At 6 months postoperatively, the median reduction in % FEV1 was 5% after WR and 3% after SR (P = .930). |
1 |
| 42. Sato S, Nakamura M, Shimizu Y, et al. The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study. BMC polm. med.. 19(1):73, 2019 Apr 04. |
Review/Other-Tx |
63 |
The objective of this study was to investigate the association between the extent of emphysema and longterm outcomes, as well as mortality and postoperative complications, in early-stage lung cancer patients after pulmonary resection. |
Emphysema was present in 63 patients. The overall survival and relapse-free survival of the nonemphysema and emphysema groups at 5 years were 89.0 and 61.3% (P<0.001), respectively, and 81.0 and 51.7%, respectively (P < 0.001). On multivariate analysis, significant prognostic factors were emphysema, higher smoking index, and higher histologic grade (p < 0.05). Significant risk factors for poor recurrence-free survival were emphysema, higher smoking index, higher histologic grade, and presence of pleural invasion (P < 0.05). Regarding Grade =II postoperative complications, pneumonia and supraventricular tachycardia were more frequent in the emphysema group than in the non-emphysema group (P=0.003 and P=0.021, respectively). |
4 |
| 43. Balekian AA, Wisnivesky JP, Gould MK. Surgical Disparities Among Patients With Stage I Lung Cancer in the National Lung Screening Trial. Chest. 155(1):44-52, 2019 01. |
Review/Other-Dx |
752 patients |
We describe surgical resection patterns of patients with early stage non-small cell lung cancer (NSCLC) in the National Lung Screening Trial (NLST) and examine whether racial disparities exist among blacks. |
Among 752 patients with clinical stage I disease, 692 patients (92%) underwent resection. Unadjusted surgical resection rates for white men, white women, black men, and black women were 92%, 91%, 61%, and 90%, respectively. In adjusted analyses, compared with white men, black men had a 28% lower risk (relative risk, 0.72; 95% CI, 0.50-0.99) of undergoing surgery; however, white women and black women underwent surgery at comparable rates as white men. The odds of undergoing limited resection instead of full resection were 70% greater in white women than white men (OR, 1.69; 95% CI, 1.08-2.65). |
4 |
| 44. Dziedzic R, Marjanski T, Binczyk F, Polanska J, Sawicka W, Rzyman W. Favourable outcomes in patients with early-stage non-small-cell lung cancer operated on by video-assisted thoracoscopic surgery: a propensity score-matched analysis. Eur J Cardiothorac Surg. 54(3):547-553, 2018 09 01. |
Review/Other-Tx |
982 |
The video-assisted thoracoscopic surgery (VATS) approach has become a standard for the treatment of early-stage nonsmall-cell lung cancer (NSCLC). Recently published meta-analyses proved the benefit of VATS versus thoracotomy for overall survival (OS) and reduction of postoperative complications. The aim of this study was to compare early outcomes, long-term survival and rate of postoperative complications of the VATS approach versus thoracotomy. |
In the propensity score-matched patient group, the VATS approach was associated with a significant benefit regarding OS (P =0.042). Although no significant difference was observed (P=0.14) in the 3-year survival rate of patients who had a thoracotomy versus VATS, the 5-year survival rate among patients with VATS increased significantly (61% vs 78%, P=0.0081). The adjusted VATS-related hazard ratio for pTNM, sex and age was 0.63 (95% confidence interval 0.40–0.98). The VATS surgical approach also reduced both the rate of postoperative atelectasis (4% for VATS vs 10% for open thoracotomy; P=0.0052) and the need for blood transfusions (4% vs 12% respectively, P=0.0054) and significantly shortened the postoperative length of stay (mean 7.25 vs 9.34days, P<0.0001). No significant differences in the 30-day mortality (1% vs 1%, P=0.66) and 90-day mortality (1% vs 1%, P=0.48) rates were observed. |
4 |
| 45. Nitsche LJ, Jordan S, Demmy T, et al. Analyzing the impact of minimally invasive surgical approaches on post-operative outcomes of pneumonectomy and sleeve lobectomy patients. J Thorac Dis 2023;15:2497-504. |
Observational-Tx |
108 patients |
We aim to investigate if there is a relationship between surgical approach and post-operative NSCLC patient outcomes |
A total of 108 patients underwent sleeve lobectomy (n=34) or pneumonectomy (n=74) for treatment of NSCLC with 18 undergoing open pneumonectomy, 56 undergoing video-assisted thoracoscopic surgery (VATS) pneumonectomy, 29 undergoing open sleeve lobectomy, and 5 undergoing VATS sleeve lobectomy. There was no significant difference in 30-day mortality (P=0.064) but there was a difference in 90-day (P=0.007). There was no difference in complication rates (P=0.234) or local recurrence rates (P=0.779). The pneumonectomy patients had a median survival of 23.6 months (95% CI: 3.8–43.4 months). The sleeve lobectomy group had a median survival of 60.7 months (95% CI: 43.3–78.2 months) (P=0.008). On multivariate analysis extent of resection (P<0.001) and tumor stage (P=0.036) were associated with survival. There was no significant difference between the VATS approach and the open surgical approach (P=0.053). |
2 |
| 46. Um SW, Kim HK, Jung SH, et al. Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer. J Thorac Oncol. 10(2):331-7, 2015 Feb. |
Experimental-Dx |
138 patients |
To compare the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with that of mediastinoscopy in patients with NSCLC. |
In total, 138 patients underwent EBUS-TBNA and 127 completed both EBUS-TBNA and mediastinoscopy. N2/N3 disease was confirmed in 59.1% of the patients. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (NPV) of EBUS-TBNA on a per-person analysis were 88.0%, 100%, 92.9%, 100%, and 85.2%, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and NPV of mediastinoscopy on a per-person analysis were 81.3%, 100%, 89.0%, 100%, and 78.8%, respectively. Significant differences in the sensitivity, accuracy, and NPV were evident between EBUS-TBNA and mediastinoscopy (p < 0.005). |
1 |
| 47. Sakata KK, Midthun DE, Mullon JJ, et al. Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens. Chest. 154(4):827-837, 2018 10. |
Observational-Dx |
73 patients |
To assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression at = 1% and = 50% on EBUS-TBNA samples compared with their corresponding surgically resected tumor. |
Sixty-one patients were included. For PD-L1 = 1%, the sensitivity, specificity, PPV, and NPV were 72%, 100%, 100%, and 80%, respectively. For PD-L1 = 50%, the sensitivity, specificity, PPV, and NPV were 47%, 93%, 70%, and 84%, respectively. The concordance rates for PD-L1 = 1% and = 50% were 87% and 82%, respectively. |
3 |
| 48. Majid A, Palkar A, Kheir F, et al. Convex Probe EBUS-guided Fiducial Placement for Malignant Central Lung Lesions. J Bronchology Interv Pulmonol. 25(4):283-289, 2018 Oct. |
Review/Other-Dx |
37 patients |
To describe the safety and feasibility of placing FM using real-time convex probe endobronchial ultrasound (CP-EBUS) for SBRT in patients with centrally located hilar/mediastinal masses or lymph nodes. |
Methods: This is a retrospective review of patients who were referred to Beth Israel Deaconess Medical Center's multidisciplinary thoracic oncology program for FM placement to pursue SBRT.Results: Thirty-seven patients who underwent real-time CP-EBUS were included. Patients had a median age of 71 years [interquartile range (IQR), 59.5 to 80.5]. The median size of the lesion was 2.2 cm (IQR, 1.4 to 3.3 cm). The median distance from the central airway was 2.4 cm (IQR, 0 to 3.4 cm). A total of 51 FMs (median of 1 per patient) were deployed in 37 patients. At the time of SBRT planning, 46 (90.2%) were confirmed radiologically in 32 patients. Patients with unsuccessful fiducial deployment (n=5) underwent a second procedure using the same technique. Of those, 3 patients had a successful fiducial placement via bronchoscopy, 1 patient required FM placement by percutaneous computed tomography-guided approach and 1 patient required FM placement through EUS by gastroenterology. |
4 |
| 49. American College of Radiology. ACR Lung-RADS v2022. Available at: https://www.acr.org/-/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf. |
Review/Other-Dx |
N/A |
This document represents a broad overview of ACR Lung-RADS® v2022 and expands upon the notes provided with the Lung-RADS table for the classification and management of findings identified at lung cancer screening (LCS). |
No abstract available. |
4 |
| 50. Park SY, Lee SJ, Han JH, Koh YW. Association between 18F-FDG uptake in PET/CT, Nrf2, and NQO1 expression and their prognostic significance in non-small cell lung cancer. Neoplasma. 66(4):619-626, 2019 07 23. |
Observational-Dx |
241 |
We evaluated the prognostic significance of NRF2, NQO1 and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) parameter and their relationship with non-small cell lung cancer (NSCLC) histology |
In squamous cell carcinoma, patients with high NQO1 expression had an inferior 5-year RFS and 5-year OS compared with patients showing a low NQO1 expression (46.7% vs. 84.2%, p=0.002; Figure 2A and 45.2% vs. 75.6%, p=0.014; Figure 2B, respectively). However, NQO1-high and NQO1-low patients showed similar 5-year RFS and OS rates in adenocarcinoma (56.3% vs. 50.3%, p=0.403; Figure 2C and 67.9% vs. 64.1%, p=0.462; Figure 2D, respectively). Nrf2 expression was not associated with RFS or OS rates in squamous cell carcinoma (p=0.34 and p=0.923, respectively). In adenocarcinoma patients, increased or decreased Nrf2 expression showed similar 5-year RFS and OS rates (p=0.242 and p=0.827, respectively). |
4 |
| 51. Colak E, Tatli S, Shyn PB, Tuncali K, Silverman SG. CT-guided percutaneous cryoablation of central lung tumors. Diagn Interv Radiol. 20(4):316-22, 2014 Jul-Aug. |
Observational-Dx |
8 |
Cryoablation has been successfully used to treat lung tumors. However, the safety and effectiveness of treating tumors adjacent to critical structures has not been fully established. We describe our experience with computed tomography (CT)-guided percutaneous cryoablation of central lung tumors and the role of ice ball monitoring. |
All procedures were technically successful; imaging after 24 hours demonstrated no residual tumor. Five tumors recurred, three of which were re-ablated successfully. A hypodense ice ball with well-defined margin was visible during the first (n=6, 55%) or second (n=11, 100%) freeze, encompassing the entire tumor in all patients, and abutting (n=7) or minimally involving (n=4) adjacent mediastinal and hilar structures. Pneumothorax developed following six procedures (60%); percutaneous treatment was applied in three of them. All patients developed pleural effusions, with one patient requiring percutaneous drainage. Transient hemoptysis occurred after six procedures (60%), but all cases improved within a week. No injury occurred to mediastinal or hilar structures. |
3 |
| 52. Zuo T, Lin W, Liu F, Xu J. Artificial pneumothorax improves radiofrequency ablation of pulmonary metastases of hepatocellular carcinoma close to mediastinum. BMC Cancer. 21(1):505, 2021 May 06. |
Observational-Dx |
32 patients |
To investigate the feasibility, safety and efficacy of percutaneous radiofrequency ablation (RFA) of pulmonary metastases from hepatocellular carcinoma (HCC) contiguous with the mediastinum using the artificial pneumothorax technique. |
The tumor size was 1.4 ± 0.6 cm in diameter. RFA procedures were all successfully performed without intra-ablative complications. Technical success was noted in 100% of the patients. Five cases of LTP and 8 cases of IDR occurred following the secondary RFA for treatment. Slight pain was reported in all patients. No major complications were observed. The 1, 2, and 3-year LTPFS rates were 90.6, 81.2, and 71.8%, and the 1, 2, and 3-year OS rates were 100, 100 and 87.5%, respectively. |
3 |
| 53. Hur J, Lee HJ, Byun MK, et al. Computed tomographic fluoroscopy-guided needle aspiration biopsy as a second biopsy technique after indeterminate transbronchial biopsy results for pulmonary lesions: comparison with second transbronchial biopsy. J Comput Assist Tomogr 2010;34:290-5. |
Observational-Dx |
77 patients |
The purpose of this study was to compare the diagnostic performance of computed tomographic (CT) fluoroscopy-guided percutaneous transthoracic needle aspiration biopsy (NAB) and transbronchial lung biopsy (TBLB) after indeterminate bronchoscopy in patients with suspected malignant pulmonary lesions. |
There were 50 (65%) malignant and 27 (35%) benign lesions. The overall sensitivity, specificity, and accuracy for diagnosing pulmonary lesions were 84%, 100%, and 91% for NAB and 50%, 100%, and 63% for TBLB. The sensitivity and accuracy for diagnosing pulmonary lesions were significantly different between the 2 groups (P = 0.019, and P = 0.008). The sensitivity and accuracy of TBLB for diagnosing lesions was significantly different according to the lesion size (P = 0.025, and P = 0.048). |
3 |
| 54. Yin ZY, Lin ZY, Wang Y, et al. Risk factors of complications after CT-guided percutaneous needle biopsy of lumps near pulmonary hilum. J Huazhong Univ Sci Technolog Med Sci 2015;35:278-82. |
Review/Other-Dx |
48 patients |
The factors influencing the incidence of common complications (pneumothorax and pulmonary hemorrhage) of CT-guided percutaneous needle biopsy of lumps near pulmonary hilum were investigated. |
?2 test revealed that pneumothorax was associated with the lesion size and depth of needle penetration, and pulmonary hemorrhage with the depth of needle penetration and needle retention time with a significant P value. Pneumothorax was observed in 7 cases (17.5%) out of 40 cases with diameter of mass greater than 3 cm, and in 6 cases (60%) out of 10 cases with depth of needle penetration greater than 4 cm. Additionally, pulmonary hemorrhage was identified in 12 cases (41.4%) out of 29 cases with needle retention time longer than 15 min, and pulmonary hemorrhage in 7 cases (70%) out of 10 cases with depth of needle penetration greater than 4 cm. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum is safe and effective. |
4 |
| 55. Rosen JE, Salazar MC, Wang Z, et al. Lobectomy versus stereotactic body radiotherapy in healthy patients with stage I lung cancer. The Journal of thoracic and cardiovascular surgery 2016;152:44-54 e9. |
Observational-Dx |
1781 |
Stereotactic body radiotherapy is an effective treatment for patients with early-stage non-small cell lung cancer who are not healthy enough to undergo surgery; however, the relative efficacy versus surgery in healthy patients is unknown. The National Cancer Database contains information on patient health and eligibility for surgery, allowing the long-term survival associated with lobectomy and stereotactic body radiotherapy to be compared in healthy patients with clinical stage I disease. |
A total of 13,562 comorbidity-free patients with clinical stage I lung cancer treated with lobectomy were compared with 1781 patients treated with stereotactic body radiotherapy. Time-stratified Cox proportional hazards models found lobectomy to be associated with a significantly better outcome than stereotactic body radiotherapy for both T1N0M0 tumors (hazard ratio, 0.38; 95% confidence interval, 0.33-0.43; P < .001) and T2N0M0 tumors 5 cm or less (hazard ratio, 0.38; confidence interval, 0.31-0.46; P < .001). In a propensity-matched analysis of 1781 pairs, lobectomy remained superior to stereotactic body radiotherapy (5-year survival 59% vs 29%, P < .001). Furthermore, when the subset of stereotactic patients who had refused a recommended surgery (n = 229) were propensity matched to lobectomy patients, lobectomy was associated with improved survival (5-year survival 58% vs 40%, P = .010). |
3 |
| 56. Till BM, Whitehorn G, Mack SJ, et al. Hospital Utilization of Stereotactic Body Radiation Therapy and Rates of Surgical Refusal. Ann Thorac Surg. 115(2):347-354, 2023 02. |
Review/Other-Dx |
129,901 patients |
It remains unclear how SBRT utilization has influenced patient refusal of surgical resection. |
Methods: A retrospective cohort analysis was completed using the National Cancer Database for patients with T1/T2 N0 M0 lesions from 2008 to 2017. Facilities were categorized into tertiles by SBRT/surgery ratio for each year of analysis. Propensity score matching was used to compare rates of surgical refusal and rates of postrefusal receipt of SBRT. Multivariable regression analysis was performed to evaluate effect size.Results: The study included 129 901 patients; 63 048 were treated at low-tertile SBRT/surgery facilities, 41 674 at middle-tertile SBRT/surgery facilities, and 25 179 at high-tertile SBRT/surgery facilities. Patients refusing surgery at high SBRT/surgery facilities had fewer comorbid conditions and smaller tumors. Rates of SBRT after surgical refusal differed (low SBRT/surgery facilities, 17.2%; high SBRT/surgery facilities, 55.9%; P < .001). In a matched cohort of 76 636, surgical refusal differed (low SBRT/surgery facilities, 4.2%; high SBRT/surgery facilities, 6.0%; P < .001). On multivariable regression, treatment at a top-tertile SBRT/surgery facility was the largest risk factor for surgical refusal (odds ratio, 3.82 [3.53-4.13]; P < .001) and was most strongly associated with postrefusal receipt of SBRT (odds ratio, 6.11 [5.09-7.34]; P < .001). |
4 |
| 57. Kubo N, Suefuji H, Nakajima M, et al. Five-Year Survival Outcomes After Carbon-Ion Radiotherapy for Operable Stage I NSCLC: A Japanese National Registry Study (J-CROS-LUNG). J Thorac Oncol 2024;19:491-99. |
Review/Other-Tx |
136 patients |
The standard therapy for stage I NSCLC is surgery, but some operable patients refuse this option and instead undergo radiotherapy. Carbon-ion radiotherapy (CIRT) is a type of radiotherapy. The Japanese prospective nationwide registry study on CIRT began in 2016. Here, we analyzed real-world clinical outcomes of CIRT for operable patients with stage I NSCLC. |
The median follow-up period was 56 months. Among 136 patients, 117 (86%) had clinical stage IA NSCLC and 19 (14%) had clinical stage IB NSCLC. There were 50 patients (37%) diagnosed clinically without having been diagnosed histologically. Most tumors (97%) were located in the periphery. The 5-year overall survival, cause-specific survival, progression-free survival, and local control rate were 81.8% (95% confidence interval [CI]: 75.1-89.2), 91.2% (95% CI: 86.0-96.8), 65.9% (95% CI: 58.2-74.6), and 95.8% (95% CI: 92.3-99.5), respectively. Multivariate analysis identified age as a significant factor for overall survival (p = 0.018), whereas age and consolidation/tumor ratio (p = 0.010 and p = 0.004) were significant factors for progression-free survival. There was no grade 4 or higher toxicity. Grade 3 radiation pneumonitis occurred in one patient. |
4 |
| 58. Zhang Y, Ma X, Shen X, et al. Surgery for pre- and minimally invasive lung adenocarcinoma. J Thorac Cardiovasc Surg. 163(2):456-464, 2022 02. |
Review/Other-Tx |
1644 patients |
Adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) are the pre- and minimally invasive forms of lung adenocarcinoma. We aimed to investigate safety results and survival outcomes following different types of surgical resection in a large sample of patients with AIS/MIA. |
A total of 1644 patients (422 AIS and 1222 MIA) were included. The overall surgical complication rate was significantly lower in patients receiving wedge resection (1.0%), and was comparable between patients undergoing segmentectomy (3.3%) or lobectomy (5.6%). Grade = 3 complications occurred in 0.1% of patients in the wedge resection group, and in a comparable proportion of patients in the segmentectomy group (1.5%) and the lobectomy group (1.5%). There was no lymph node metastasis. The 5-year recurrence-free survival rate was 100%. The 5-year overall survival rate in the entire cohort was 98.8%, and was comparable among the wedge resection group (98.8%), the segmentectomy group (98.2%), and the lobectomy group (99.4%). |
4 |
| 59. Gao HJ, Jiang ZH, Gong L, et al. Video-Assisted Vs Thoracotomy Sleeve Lobectomy for Lung Cancer: A Propensity Matched Analysis. Ann Thorac Surg. 108(4):1072-1079, 2019 10. |
Review/Other-Tx |
78 cases |
In this retrospective study, we evaluated the safety and efficacy of video-assisted thoracic surgery (VATS) sleeve lobectomy for patients with centrally located non-small cell lung cancer. |
Among all patients, the VATS group showed significantly better recurrence-free survival and overall survival than the thoracotomy group (P = .025 and P = .026, respectively) with smaller total tumor size and earlier pathological tumor-node-metastasis (TNM) stage. Nevertheless, after matching, the recurrence-free survival (50.9% vs 48.7%; P = .445) and overall survival (79.5% vs 66.7%; P = .198) were not significantly different. There was significantly less blood loss (228 vs 246 mL; P = .022), shorter thoracic drainage stay (4.6 vs 6.8 days; P < .001), and postoperative hospital stay (9.2 vs 11.3 days; P = .033) in the VATS group. Multivariate Cox analyses demonstrated that the surgical procedure was not an independent prognostic factor for recurrence-free survival, not only for patients with an invasive component size of 3 cm or less and negative lymphatic invasion, but for locally advanced patients with an invasive tumor size >3 cm (hazard ratio: 0.94; 95% confidence interval: 0.36-2.45; P = .55) or positive lymphatic invasion (hazard ratio: 0.91; 95% confidence interval: 0.35-2.39; P = .41). |
4 |
| 60. Murgu S, Chen AC, Gilbert CR, et al. A Prospective, Multicenter Evaluation of Safety and Diagnostic Outcomes With Robotic-Assisted Bronchoscopy: Results of the Transbronchial Biopsy Assisted by Robot Guidance in the Evaluation of Tumors of the Lung (TARGET) Trial. Chest 2025;168:539-55. |
Observational-Dx |
715 patients |
What is the clinical safety, navigational success, and diagnostic yield of RAB for biopsy of PPLs in a broad range of patients in a real-world setting? |
Among 715 patients at 21 sites, 679 met study criteria and underwent RAB (mean age 68.7 years; 55.4% female; 86.5% White; 77.5% with current/past tobacco use). Mean (range) lesion size was 20.9 (7.0-63.0) mm; median (interquartile range) distance from the pleural surface was 5 (0-16) mm. Most lesions were solid (n = 587 [86.6%]) and within the outer two-thirds of the lung (n = 593 [87.5%]). The primary end point was observed in 26 (3.8%) patients (19 pneumothorax, 7 bleeding, and 0 respiratory failure). Users reported that RAB reached the lesion in 670 (98.7%) of 679 cases, and lesion location was confirmed with radial probe endobronchial ultrasound in 607 (91.7%) of 662 cases; sampling through the bronchoscope was performed in 675 (99.4%) of 679 cases. Prevalence of malignancy was 64.1% through 12 months. Adjudicated diagnostic yield was 61.6% when calculated with the American Thoracic Society/American College of Chest Physicians (CHEST) definition for strict reporting criteria. Sensitivity for malignancy was 78.8%. |
2 |
| 61. Ohta K, Shimohira M, Iwata H, et al. Percutaneous fiducial marker placement under CT fluoroscopic guidance for stereotactic body radiotherapy of the lung: an initial experience. J Radiat Res 2013;54:957-61. |
Review/Other-Dx |
8 patients |
To describe our initial experience with the VISICOIL, which is the first percutaneous fiducial marker approved for stereotactic body radiotherapy in Japan, and to evaluate its technical and clinical efficacy, and safety. |
Eight patients underwent this procedure under CT fluoroscopic guidance. One patient had two tumors, so the total number of procedures was nine. We evaluated the technical and clinical success rates of the procedure and the frequencies of complications. Technical success was defined as when the fiducial marker could be placed at the target site, and clinical success was defined as when stereotactic body radiotherapy could be performed without the marker dropping out of position. The technical success rate was 78% (7/9). In one of the two failed cases, we aimed to place the marker inside the tumor, but misplaced it beside the tumor. In the other failed case, we successfully placed the marker beside the tumor as planned; however, the marker migrated to near the pleura after the patient stopped holding their breath. None of the markers dropped out of place, so the clinical success rate was 100% (9/9). The complication rates were as follows: pneumothorax: 56% (5/9), pneumothorax necessitating chest tube placement: 44% (4/9), focal intrapulmonary hemorrhaging: 67% (6/9), hemoptysis: 11% (1/9), mild hemothorax 11% (1/9), air embolism 0% (0/9), and death 0% (0/9). |
4 |
| 62. Bonichon F, Palussiere J, Godbert Y, et al. Diagnostic accuracy of 18F-FDG PET/CT for assessing response to radiofrequency ablation treatment in lung metastases: a multicentre prospective study. Eur J Nucl Med Mol Imaging. 40(12):1817-27, 2013 Dec. |
Review/Other-Dx |
78 |
To evaluate the safety and efficacy of video-assisted thoracic surgery (VATS) sleeve lobectomy for patients with centrally located non-small cell lung cancer. |
Methods: All consecutive patients who received VATS sleeve lobectomy (n = 54) and thoracotomy sleeve lobectomy (n = 94) were analyzed retrospectively; after propensity score matching, 78 paired cases were selected for further statistical analysis.Results: Among all patients, the VATS group showed significantly better recurrence-free survival and overall survival than the thoracotomy group (P = .025 and P = .026, respectively) with smaller total tumor size and earlier pathological tumor-node-metastasis (TNM) stage. Nevertheless, after matching, the recurrence-free survival (50.9% vs 48.7%; P = .445) and overall survival (79.5% vs 66.7%; P = .198) were not significantly different. There was significantly less blood loss (228 vs 246 mL; P = .022), shorter thoracic drainage stay (4.6 vs 6.8 days; P < .001), and postoperative hospital stay (9.2 vs 11.3 days; P = .033) in the VATS group. Multivariate Cox analyses demonstrated that the surgical procedure was not an independent prognostic factor for recurrence-free survival, not only for patients with an invasive component size of 3 cm or less and negative lymphatic invasion, but for locally advanced patients with an invasive tumor size >3 cm (hazard ratio: 0.94; 95% confidence interval: 0.36-2.45; P = .55) or positive lymphatic invasion (hazard ratio: 0.91; 95% confidence interval: 0.35-2.39; P = .41). |
4 |
| 63. Zhong J, Chen J, Lin R, et al. Phrenic nerve injury after the percutaneous microwave ablation of lung tumors: A single-center analysis. J Cancer Res Ther. 18(7):2001-2005, 2022 Dec. |
Review/Other-Tx |
455 |
This study aimed to analyze the cases of phrenic nerve injury caused by the percutaneous microwave ablation of lungtumors conducted at our center and to explore the risk factors. |
Among the 455 patients included in this study, 348 had primary lung cancer, and 107 had oligometastatic cancer. A totalof 579 lesions were detected, with maximum diameter of 1.27 ± 0.55 cm, and the ablation energy was 9,000 (4,800–72,000) J.Six patients developed phrenic nerve injury, with an incidence of 1.32%. For these six patients, the shortest distance from the lesionedge to the phrenic nerve was 0.75 ± 0.48 cm, and the ablation energy was 10,500 (8,400–34,650) J. There were statisticallysignificant differences in phrenic nerve injury among groups 1, 2, and 3 (P < 0.05). In patients with a distance (d) = 2 cm, there wereno significant differences in tumor diameter and energy between the phrenic nerve injury group and the non-injury group (P = 0.80;P = 0.41). In five out of six patients, the diaphragm level completely recovered to the pre-procedure state, and the recovery timeof the phrenic nerve was 9.60 ± 5.60 months. Another one was re-examined 11 months after the procedure, and the level of thediaphragm on the affected side had partially recovered. |
4 |
| 64. Wrobel MM, Cahalane AM, Pachamanova D, et al. Comparison of expected imaging findings following percutaneous microwave and cryoablation of pulmonary tumors: ablation zones and thoracic lymph nodes. Eur Radiol. 32(12):8171-8181, 2022 Dec. |
Review/Other-Tx |
36 |
To compare temporal changes of ablation zones and lymph nodes following lung microwave ablation (MWA) and cryoablation. |
Ablation zones of 59 tumors treated in 45 sessions (16 MWA, 29 cryoablation) in 36 patients were evaluated. Differences in the time to 75% volume reduction between modalities were not detected. Following MWA, half of ablation zones required an estimated time of 340 days to achieve 75% volume reduction compared to 214 days following cryoablation (p=.30). Thoracic lymph node sizes after 33 sessions (13 MWA, 20 cryoablation) differed between modalities (baseline-32 days, p=.01; 32-123 days, p=.001). Following MWA, lymph nodes increased on average by 38mm2 (95%CI, 5.0–70.7; p=.02) from baseline to 32 days, followed by an estimated decrease of 50mm2 (32-123 days; p=.001). Following cryoablation, changes in lymph nodes were not detected (baseline-32 days, p=.33). |
4 |
| 65. Abrishami Kashani M, Murphy MC, Saenger JA, et al. Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors. European radiology 2023;33:5740-51. |
Review/Other-Dx |
116 patients |
To compare the incidence of persistent air leak (PAL) following cryoablation vs MWA of lung tumors when the ablation zone includes the pleura. |
In total, 260 tumors (mean diameter, 13.1 mm ± 7.4; mean distance to pleura, 3.6 mm ± 5.2) in 116 patients (mean age, 61.1 years ± 15.3; 60 women) and 173 sessions (112 cryoablations, 61 MWA) were included. PAL occurred after 25/173 (15%) sessions. The incidence was significantly lower following cryoablation compared to MWA (10 [9%] vs 15 [25%]; p = .006). The odds of PAL adjusted for the number of treated tumors per session were 67% lower following cryoablation (odds ratio = 0.33 [95% CI, 0.14-0.82]; p = .02) vs MWA. There was no significant difference in time-to-LTP between ablation modalities (p = .36). |
4 |
| 66. Baust JG, Gage AA, Bjerklund Johansen TE, Baust JM. Mechanisms of cryoablation: clinical consequences on malignant tumors. Cryobiology 2014;68:1-11. |
Review/Other-Dx |
N/A |
To discuss the biology of cancer, which has profound implications for the diverse therapies of the disease, including cryosurgery. |
No results stated in abstract. |
4 |
| 67. Fakiris AJ, McGarry RC, Yiannoutsos CT, et al. Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: four-year results of a prospective phase II study. Int J Radiat Oncol Biol Phys. 2009; 75(3):677-682. |
Observational-Tx |
70 patients |
To report the 50-month results of a prospective Phase II trial of SBRT in medically inoperable patients. |
Median follow-up was 50.2 months (range, 1.4-64.8 months). Kaplan-Meier local control at 3 years was 88.1%. Regional (nodal) and distant recurrence occurred in 6 (8.6%) and 9 (12.9%) patients, respectively. Median survival was 32.4 months and 3-year OS was 42.7% (95% CI, 31.1%-54.3%). Cancer-specific survival at 3 years was 81.7% (95% CI, 70.0%-93.4%). For patients with T1 tumors, median survival was 38.7 months (95% CI, 25.3-50.2) and for T2 tumors median survival was 24.5 months (95% CI, 18.5-37.4) (P=0.194). Tumor volume (=5 cc, 5-10 cc, 10-20 cc, >20 cc) did not significantly impact survival: median survival was 36.9 months (95% CI, 18.1-42.9), 34.0 (95% CI, 16.9-57.1), 32.8 (95% CI, 21.3-57.8), and 21.4 months (95% CI, 17.8-41.6), respectively (P=0.712). There was no significant survival difference between patients with peripheral vs central tumors (median survival 33.2 vs 24.4 months, P=0.697). Grade 3 to 5 toxicity occurred in 5/48 patients with peripheral lung tumors (10.4%) and in 6/22 patients (27.3%) with central tumors (Fisher’s exact test, P=0.088). Based on the study results, use of SBRT results in high rates of local control in medically inoperable patients with stage I NSCLC. |
2 |
| 68. Choi S, Park J. Surgical outcomes and prognosis of non-small-cell lung cancer in patients with chronic lung diseases: a retrospective analysis. Eur J Cardiothorac Surg. 58(2):357-364, 2020 08 01. |
Review/Other-Tx |
1101 patients |
This study aimed to examine postsurgical outcomes of patients with comorbid lung diseases treated for lung cancer. |
There were 1101 patients in group A, 266 patients in group B, 62 patients in group C and 97 patients in group D. In the chronic lung disease groups (B, C and D), there was a high percentage of smoking history (86.5%, 79.0% and 92.8%, respectively; P < 0.01). The occurrence rate of postoperative lung complications and operative mortality rates were higher in patients with chronic lung disease. Groups A, B, C and D contained 819 (74.4%), 159 (59.8%), 43 (69.4%) and 65 (67.0%) stage I patients, respectively (P < 0.01). The groups showed significant differences in overall survival and disease-free survival (all P < 0.01). The presence of combined pulmonary fibrosis and emphysema was the only significant negative prognostic factor for overall survival. |
4 |
| 69. Trumm CG, Haussler SM, Muacevic A, et al. CT fluoroscopy-guided percutaneous fiducial marker placement for CyberKnife stereotactic radiosurgery: technical results and complications in 222 consecutive procedures. J Vasc Interv Radiol 2014;25:760-8. |
Review/Other-Dx |
196 patients |
To evaluate technical outcome and safety of computed tomographic (CT) fluoroscopy-guided percutaneous fiducial marker placement before CyberKnife stereotactic radiosurgery. |
One hundred ninety-six patients (age, 61.5 y ± 13.1) underwent percutaneous placement of 321 fiducial markers (mean per tumor, 1.2 ± 0.5; range, 1-4) in 37 primary tumors and 227 metastases in the thorax (n = 121), abdomen (n = 122), and bone (n = 21). Fiducial marker placement was technically successful in all procedures: intratumoral localization in 193 (60.1%), at tumor margin in 50 (15.6%), and outside of tumor in 78 cases (24.3%; mean distance to marker, 0.4 cm ± 0.6; range, 0-2.9 cm). Complications were observed in 63 placement procedures (28.4%), including minor self-limiting pneumothorax (n = 21; SIR class B) and self-limiting pulmonary hemorrhage (n = 35; SIR class A), and major pneumothorax requiring thoracostomy/drainage insertion (n = 14; SIR class D) and systemic toxicity of local anesthetic drug (n = 1; SIR class D). |
4 |
| 70. Karam E, Tabutin M, Mastier C, et al. Curative-intent treatment of pulmonary metastases from colorectal cancer: A comparison between imaging-guided thermal ablation and surgery. J Surg Oncol. 127(1):183-191, 2023 Jan. |
Review/Other-Tx |
146 patients |
We compared the outcomes of patients with PM, treated with resection or ablation. |
One hundred and fourty-six patients were included, 65 (44.5%) underwent surgery and 81 (55.5%) underwent IGTA. After PSM analysis, each group contained 46 patients. IGTA patients had a lower morbidity rate (13.1% vs. 15.2%, p = 0.028) and a shorter length of stay (5.13 vs. 2.63 days, p < 0.001). Oncological outcomes were similar in both groups with 5-year OS of 80% and 5-year progression-free survival (PFS) of 30% (p = 0.657 and p = 0.504, respectively) with similar recurrence patterns. |
4 |
| 71. Hasegawa T, Takaki H, Kodama H, et al. Impact of the Ablative Margin on Local Tumor Progression after Radiofrequency Ablation for Lung Metastases from Colorectal Carcinoma: Supplementary Analysis of a Phase II Trial (MLCSG-0802). J Vasc Interv Radiol. 34(1):31-37.e1, 2023 Jan. |
Observational-Tx |
70 patients (49 male, 21 female) |
To explore what extent of ablative margin depicted by computed tomography (CT) immediately after radiofrequency (RF) ablation is required to reduce local tumor progression (LTP) for colorectal cancer (CRC) lung metastases. |
The mean ablative margin was 2.7 mm ± 1.3 (range, 0.4-7.3 mm). LTP developed in 6 tumors (6%, 6/95) 6-19 months after RF ablation. The LTP rate was significantly higher when the margin was less than 2 mm (P = .023). A margin of <2 mm was also found to be a significant factor for LTP (P = .048) on multivariate analysis and validated using the bootstrap method (P = .025). |
2 |
| 72. Tetta C, Carpenzano M, Algargoush ATJ, et al. Non-surgical Treatments for Lung Metastases in Patients with Soft Tissue Sarcoma: Stereotactic Body Radiation Therapy (SBRT) and Radiofrequency Ablation (RFA). Curr Med Imaging. 17(2):261-275, 2021. |
Meta-analysis |
7 studies |
To evaluate the outcomes and complications of these procedures in patients with lung metastases from soft tissue sarcoma (STS). |
The mean age ranged from 47.9 to 64 years in the SBRT group and from 48 to 62.7 years in the RFA group. The most common histologic subtype was, in both groups, leiomyosarcoma. In the SBRT group, median overall survival ranged from 25.2 to 69 months and median disease- free interval was from 8.4 to 45 months. Two out of seven studies reported G3 and one G3 toxicity, respectively. In RFA patients, overall survival ranged from 15 to 50 months. The most frequent complication was pneumothorax. Local control showed a high percentage for both procedures. |
Good |
| 73. Safi S, Rauch G, op den Winkel J, et al. Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer. Respiration. 89(6):550-7, 2015. |
Observational-Dx |
116 patients |
We analyzed data from our prospective database to evaluate the recurrence and survival rates and assess the extent to which the type of treatment explains outcome differences. |
The SLR patients were younger and exhibited better performance status. The RT patients had larger tumors. After adjusting for age and tumor size, there were differences between the different treatments in terms of the PR rate, but no differences were observed in overall (OS) or disease-free survival. The hazard ratio for PR comparing SLR versus RT adjusted for age and tumor size was 2.73 (95% confidence interval, CI, 0.72-10.27) and that for SLR versus RFA was 7.57 (95% CI 1.94-29.47). |
3 |
| 74. Wu X, Uhlig J, Blasberg JD, et al. Microwave Ablation versus Stereotactic Body Radiotherapy for Stage I Non-Small Cell Lung Cancer: A Cost-Effectiveness Analysis. J Vasc Interv Radiol. 33(8):964-971.e2, 2022 08. |
Review/Other-Dx |
NA |
To assess the cost effectiveness of microwave ablation (MWA) and stereotactic body radiotherapy (SBRT) for patients with inoperable stage I non-small cell lung cancer (NSCLC). |
MWA yielded a health benefit of 2.31 QALYs at a cost of $195,331, whereas SBRT yielded a health benefit of 2.33 QALYs at a cost of $225,271. The incremental cost-effectiveness ratio was $1,480,597/QALY, indicating that MWA is the more cost-effective strategy. The conclusion remains unchanged in probabilistic sensitivity analysis with MWA being the optimal cost strategy in 99.84% simulations. One-way sensitivity analyses revealed that MWA remains cost effective when its annual recurrence risk is <18.4% averaged over 5 years, when the SBRT annual recurrence risk is >1.44% averaged over 5 years, or when MWA is at least $7,500 cheaper than SBRT. |
4 |
| 75. Zellweger M, Abdelnour-Berchtold E, Krueger T, Ris HB, Perentes JY, Gonzalez M. Surgical treatment of pulmonary metastasis in colorectal cancer patients: Current practice and results. Crit Rev Oncol Hematol 2018;127:105-16. |
Review/Other-Dx |
180 articles |
We discuss prognostic factors of survival after lung metastasectomy in CRC patients under several scenarios (with/ without prior liver metastases; repetitive pulmonary resections). |
We reviewed all studies (2005-2015) about pulmonary metastases surgical management with curative intent in CRC patients, with a minimum threshold on the number of patients reported (without prior liver metastases: n = 100; with prior resection of liver metastases: n = 50; repetitive thoracic surgery: n = 30). The picture of the prognostic factors of survival is nuanced: surgical management demonstrates clear successes and steady progress, yet there is no single success criterion; stratification of patients and selection bias impact the conclusions. Surgical management of liver and lung metastases may prolong life or cure CRC patients, provided the lesions are fully resected and patients carefully selected. Repeat lung metastasectomy is a safe approach to treat patients in selected cases. |
4 |
| 76. Markowiak T, Dakkak B, Loch E, et al. Video-assisted pulmonary metastectomy is equivalent to thoracotomy regarding resection status and survival. J Cardiothorac Surg. 16(1):84, 2021 Apr 15. |
Observational-Tx |
251 patients |
The aim of this study was to evaluate the role of video-assisted thoracoscopic surgery (VATS) in pulmonary metastectomy with curative intent. |
A total of 251 patients underwent metastectomy with curative intent. VATS was performed in 63 (25.1%) patients, 54 (85.7%) of whom had a solitary metastasis. Wedge resection was the most performed procedure in patients treated with VATS (82.5%, n = 52) and thoracotomy (72.3%, n = 136). Postoperative revisions were necessary in nine patients (4.8%), and one patient died of pulmonary embolism after thoracotomy (0.5%). Patients were discharged significantly faster after VATS than after thoracotomy (p < 0.001). Complete (R0) resection was achieved in 89% of patients. The median recurrence-free survival was 11 months (95% confidence interval 7.9-14.1). During follow-up, eight (12.7%) patients in the VATS group and 42 (22.3%) patients in the thoracotomy group experienced recurrence (p = 0.98). The median overall survival was 61 months (95% confidence interval 46.1-75.9), and there was no significant difference with regard to the surgical method used (p = 0.34). |
2 |
| 77. Cho J, Ko SJ, Kim SJ, et al. Surgical resection of nodular ground-glass opacities without percutaneous needle aspiration or biopsy. BMC Cancer. 14:838, 2014 Nov 18. |
Observational-Dx |
324 patients |
In this study, we evaluated the rate of malignancy, complications related to surgery, and the cost benefits of resecting nGGOs without prior tissue diagnosis when those nGGOs were highly suspected for malignancy based on their size, radiologic characteristics, and clinical courses. |
Among 356 nGGOs of 324 patients, 330 (92.7%) nGGOs were resected without prior histologic confirmation. The rate of malignancy was 95.2% (314/330). In the multivariate analysis, larger size was found to be an independent predictor of malignancy (odds ratio, 1.086; 95% confidence interval, 1.001-1.178, p =0.047). A total of 324 (98.2%) nGGOs were resected by video-assisted thoracoscopic surgery (VATS), and the rate of surgery-related complications was 6.7% (22/330). All 16 nGGOs diagnosed as benign nodules were resected by VATS, and only one patient experienced postoperative complications (prolonged air leak). Direct surgical resection without tissue diagnosis significantly reduced the total costs, hospital stay, and waiting time to surgery. |
3 |
| 78. Herskovitz E, Solomides C, Barta J, Evans N 3rd, Kane G. Detection of lung carcinoma arising from ground glass opacities (GGO) after 5 years - A retrospective review. Respir Med. 196:106803, 2022 05. |
Review/Other-Dx |
442 patients |
Our aim was to determine the frequency of diagnosed carcinoma arising from GGO detected beyond 5 years of surveillance. |
Of the 442 cases of lung carcinoma, 32 (7%) were found that arose from pure GGOs and were ultimately diagnosed as cancer. Among the subgroup of GGOs, 78% (n = 25) were diagnosed within five years of surveillance, but up to 22% (n = 7) required between five and twelve years of serial follow up prior to definitive diagnosis. In order to detect 95% of cancers, GGOs would need to be followed for 7.9-12.7 years based upon a Kaplan-Meier estimate (p = 0.05). No patients who had lung carcinoma arising from GGOs died (0/32) within a follow-up time of one to three years. These data suggest that a greater number of lung carcinomas would be detected upon routine follow up of GGOs that extended beyond the current recommendation of five years. The overall survival of the cohort was 100%, consistent with existing data that these cancers are indolent. |
4 |
| 79. Koike H, Ashizawa K, Tsutsui S, et al. Surgically resected lung adenocarcinoma: do heterogeneous GGNs and part-solid nodules on thin-section CT show different prognosis?. Jpn J Radiol. 41(2):164-171, 2023 Feb. |
Observational-Dx |
242 patients |
This study aimed to evaluate the clinical courses of patients with surgically resected stage IA pulmonary adenocarcinoma (Ad) who exhibited heterogeneous ground-glass nodules (GGNs) or part-solid nodules on thin-section computed tomography (TSCT) and to clarify the prognostic differences between them. |
There were no cases of recurrent pulmonary Ad or death from the primary disease in the heterogeneous GGN group. In the part-solid nodule group, recurrent pulmonary Ad and death from the primary disease were observed in 12 and 6 of 181 patients, respectively. Heterogeneous GGNs were associated with significantly longer DFS than part-solid nodules (p = 0.042). While, there was no significant difference in OS between the two groups (p = 0.134). Pathological diagnoses were available for all 242 patients. 181 part-solid nodules were classified into 116 invasive Ads, 54 minimally invasive Ads (MIAs), and 11 Ad in situ (AIS) lesions, and 61 heterogeneous GGNs were classified into 18 invasive Ads, 25 MIAs, and 18 AIS lesions. |
3 |
| 80. Li D, Deng C, Wang S, Li Y, Zhang Y, Chen H. Ten-year follow-up of lung cancer patients with resected adenocarcinoma in situ or minimally invasive adenocarcinoma: Wedge resection is curative. J Thorac Cardiovasc Surg. 164(6):1614-1622.e1, 2022 12. |
Review/Other-Tx |
1696 patients |
This study aimed to reveal the long-term outcomes of patients with lung cancer with adenocarcinoma in situ or minimally invasive adenocarcinoma after resection, in the context of the different surgical resection types. |
After reevaluating the histological findings of 1696 patients with lung adenocarcinoma, we enrolled 53 with adenocarcinoma in situ and 72 with minimally invasive adenocarcinoma for analyses. Of all 125 patients with adenocarcinoma in situ/minimally invasive adenocarcinoma, 86 (68.8%) were female, 114 (91.2%) were nonsmokers, and most of them (78, 62.4%) underwent wedge resection. The median follow-up period after surgery was 111 months. The 10-year recurrence-free survivals of adenocarcinoma in situ and minimally invasive adenocarcinoma were all 100%, and the 10-year overall survivals of adenocarcinoma in situ and minimally invasive adenocarcinoma were 98.1% and 97.2%, respectively. There was no difference in 10-year recurrence-free survival between patients who underwent lobectomy and wedge resection. EGFR mutations were detected in 63.1% (41/65) of patients who underwent mutational analysis. The risks of developing second primary lung cancer for adenocarcinoma in situ and minimally invasive adenocarcinoma 10 years after resection were 8.4% and 4.3% (P = .298), respectively, and were not correlated with EGFR mutation status (P = .525). |
4 |
| 81. National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation. Measuring Sex, Gender Identity, and Sexual Orientation. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved.; 2022. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
