Surgical resection of nodular ground-glass opacities without percutaneous needle aspiration or biopsy

BMC Cancer

Choon-Taek Lee¹  Jae Ho Lee¹  Sanghoon Jheon²  Kwhanmien Kim²  Sukki Cho²  Ho Il Yoon¹  Young-Jae Cho¹  Jong Sun Park¹  Yeon Joo Lee¹  Se Joong Kim¹  Sung-Jun Ko¹  Jaeyoung Cho¹ 

[1]Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

[2]Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

关键词: Percutaneous needle aspiration or biopsy;    Surgery;    Computed tomography;    Lung cancer;    Nodular ground-glass opacity;   

Others  :  1118244
DOI  :  10.1186/1471-2407-14-838

 received in 2014-08-06, accepted in 2014-11-04,  发布年份 2014

【 摘 要 】

Background

Percutaneous needle aspiration or biopsy (PCNA or PCNB) is an established diagnostic technique that has a high diagnostic yield. However, its role in the diagnosis of nodular ground-glass opacities (nGGOs) is controversial, and the necessity of preoperative histologic confirmation by PCNA or PCNB in nGGOs has not been well addressed.

Methods

We here evaluated the rates of malignancy and surgery-related complications, 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. Patients who underwent surgical resection of nGGOs without preoperative tissue diagnosis from January 2009 to October 2013 were retrospectively analyzed.

Results

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.

Conclusions

With careful selection of nGGOs that are highly suspicious for malignancy, surgical resection of nGGOs without tissue diagnosis is recommended as it reduces costs and hospital stay.

【 授权许可】

   
2014 Cho et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 4.

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