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Biopsy testing in an inoperable, non-small cell lung cancer population: a retrospective, real-life study in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Cent Hosp, Dept Resp Med, SE-80187 Gavle, Sweden; Karolinska Inst, Stockholm, Sweden..
Skane Univ Hosp, Dept Pathol, Lund, Sweden..
AstraZeneca Nord Balt, Sodertalje, Sweden..
Karolinska Univ Hosp, Dept Radiol, Stockholm, Sweden.;Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden..
2015 (English)In: Journal of Thoracic Disease, ISSN 2072-1439, E-ISSN 2077-6624, Vol. 7, no 12, 2226-2233 p.Article in journal (Refereed) PublishedText
Abstract [en]

Background: Correct diagnosis and staging are required for optimal treatment choice in lung cancer patients. This retrospective, patient medical records study investigated the clinical practice of lung cancer biopsy procedures and testing in Sweden. Methods: Consecutive patients with a recorded inoperable, malignant tumour of bronchus and lung were retrospectively identified at geographically widespread pulmonology clinics (NCT01139619). Data, including diagnostic sampling methodology [bronchoscopy, biopsy by pulmonologist and computed tomography (CT)-guided biopsy], were collected for patients diagnosed between 1 June 2009-31 May 2010, and analysed using descriptive statistics. A study-predefined algorithm, including six criteria on tumour localization and size, forced expiratory volume in one second (FEV1), blood saturation and risk of bleeding theoretically categorizing patient suitability for CT-guided biopsy, was used. Results: In total, 132 patients (mean age 68 years, 48% women, 61% adenocarcinoma, 86% current/former smokers, 96% performance status <= 2, mean FEV1 volume >= 2 L) were included. The majority were examined by > 1 diagnostic procedure (29% by CT-guided biopsy). Median overall time from first hospital contact to established diagnosis was 12.0 days (10.0 and 28.0 days for bronchoscopy and CT-guided biopsy, respectively). No major differences in lung function, age, performance status or predefined algorithm criteria were noted for patients examined by CT-guided biopsy versus bronchoscopy or biopsy. Complications were reported for 11 patients, including pneumothorax in six patients. Histopathology was used most frequently to diagnose and subtype (70%), although 66% of patients examined solely by bronchoscopy were diagnosed by cytology. For 26.5% of patients, epidermal growth factor receptor (EGFR) mutation testing was recorded. Conclusions: No limitations regarding patient suitability or methodological complications were noted in this real-life, observational study. The CT-guided biopsy is a relatively safe and well-established method, and may need to be utilized further to fulfil current and future demands for faster diagnosis and high quality tissue as new tumour markers and targeted therapies become available.

Place, publisher, year, edition, pages
2015. Vol. 7, no 12, 2226-2233 p.
Keyword [en]
Non-small cell lung cancer (NSCLC), biopsy, medical records, pathology, epidermal growth factor receptor (EGFR)
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-283814DOI: 10.3978/j.issn.2072-1439.2015.12.52ISI: 000372091300043PubMedID: 26793344OAI: oai:DiVA.org:uu-283814DiVA: diva2:919644
Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2016-04-14Bibliographically approved

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Koyi, Hirsh
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