Preoperative bronchoscopic cancer confirmation does not increase risk of recurrence in stage1A non-small cell lung cancer.
OBJECTIVE
This study was conducted to evaluate the risk of recurrence possibly caused by preoperative bronchoscopic cancer confirmation in stage1A non-small cell lung cancer.


METHODS
One hundred and seventy-nine cases of peripheral non-small cell lung cancer (including 151 adenocarcinoma) with no more than 3 cm in their tumor longer diameter were selected. All patients underwent preoperative diagnostic bronchoscopy followed by lobectomy, and were demonstrated to have pathologically free of lymph node involvement and pleural involvement. Radiological and pathological low-grade adenocarcinomas were excluded. Of 179 cases, 95 were confirmed lung cancer by bronchoscope (Group 1) and rest 84 had failed cancer confirmation by bronchoscope before surgery (Group 2). Forty-eight pairs for non-small cell lung cancer and 41 pairs for adenocarcinoma were identified from each group by propensity caliper matching. Kaplan-Meier method and log-rank test were performed on matched groups, and Cox proportional hazard model analysis was performed on whole matched cases.


RESULTS
Log-rank test revealed no significant inferiority of recurrence-free survival of Group 1 in both all-NSCLC and adenocarcinoma subset. Cox proportional hazard model analysis also revealed that the 'presence of preoperative bronchoscopic cancer confirmation' dose not increase risk of recurrence in both NSCLC and adenocarcinoma subset.


CONCLUSIONS
It is unlikely that preoperative bronchoscopic cancer confirmation would increase recurrence risk in stage1A non-small cell lung cancer; however, a future prospective study with larger cohorts would be warranted to validate the results.
['Abe|Jiro|J|http://orcid.org/0000-0002-0820-0360', 'Okazaki|Toshimasa|T|', 'Kikuchi|Naohiko|N|', 'Takahashi|Satomi|S|', 'Sakurada|Akira|A|', 'Okada|Yoshinori|Y|']
D000230:Adenocarcinoma D000328:Adult D000368:Aged D001999:Bronchoscopy D002289:Carcinoma, Non-Small-Cell Lung D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D009367:Neoplasm Staging D011013:Pneumonectomy D011183:Postoperative Complications D011300:Preoperative Care D016016:Proportional Hazards Models D011446:Prospective Studies D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D047368:Tumor Burden
Bronchoscope Diagnosis Lung adenocarcinoma Prognostic factor