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Carmen Centeno Clemente
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P2.05 - Interventional Diagnostic/Pulmonology (ID 168)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.05-15 - Radial Endobronchial Ultrasound-Guided Transbronchial Biopsy in Peripheral Lung Lesions. What Can Cryobiopsy Contribute? (Now Available) (ID 865)
10:15 - 18:15 | Author(s): Carmen Centeno Clemente
- Abstract
Background
Radial probe endobronchial ultrasound (RP-EBUS) is a modern technique for diagnosis of peripheral lung lesions. The addition of transbronchial cryobiopsy (TBCB) could increase the diagnostic value for RP-EBUS. AIM: To evaluate the efficacy of RP-EBUS guided TBCB for diagnosis of peripheral lung lesions.
Method
We collected 60 patients with peripheral lung diseases. Were excluded 15 patients for not be fit for general anesthesia (necessary for TBCB) or high risk of bleeding. 45 patients were subjected to forceps transbronchial biopsy (forceps TBB) and TBCB guided by RP-EBUS. The diagnostic outcomes including digital assessment for qualitative and quantitative measures of collected samples were detected. Also, the associated complications were recorded.
Result
The diagnostic yields for forceps TBB versus TBCB is detailed in Table 1. TBCB has achieved higher accuracy than forceps TBB (ROC area of 0.88 versus 0.84 respectively), with no statistical difference between their values (p=0.32). The combination between both techniques has achieved excellent accuracy (ROC area 0.91). In 36 cases were possible the anatomopathological diagnosis with both type of samples, there were significant statistical differences (p ≤ 0.05) in favour of TBCB when compared to forcep TBB regarding; mean biopsy diameter, mean biopsy surface area, mean biopsy necrosis, percentage and mean biopsy viable tissue area. Only two patients had significant complications (pneumothorax; hypoxemia), and 8 moderate bleeding.
Conclusion
Conclusions: RP-EBUS guided TBCB is a safe and effective technique for diagnosis of peripheral lung lesions. TBCB could achieve higher diagnostic value than forceps TBB due to better quantity and quality of the samples.
The project was partially funded by SEPAR, grant AEER 2016, grant FUCAP 2017 and Egyptian Ministry of Higher Education.
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P2.13 - Staging (ID 315)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Staging
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.13-05 - Endobronchial Ultrasound for Mediastinal Restaging in Non-Small Cell Lung Cancer (Now Available) (ID 858)
10:15 - 18:15 | Author(s): Carmen Centeno Clemente
- Abstract
Background
The adequate mediastinal restaging following neo-adjuvant therapy (NAT) in operable patients with non-small cell lung cancer (NSCLC) and N2 spread is crucial. Mediastinoscopy is the gold standard for mediastinal restanging, but endosonographic procedures are less invasive and can be an alternative. AIM: Evaluate the role of endobronchial ultrasound-guided transbronchial needle aspirate EBUS-TBNA in mediastinal the restaging of NSCLC.
Method
Prospective study with 32 patients with CPNCP N2 spread confirmed by TNBA-EBUS, collected from June 2010 to October 2018. These patients were subjected to neoadjuvant treatment (chemotherapy or radio-chemotherapy), subsequently were performed mediastinum restage with TNBA-EBUS. The negative cases were subjected to mediastinoscopy or thoracotomy.
Result
Of the 32 cases, the basal characteristics are detailed in table 1. Were analysed 229 lymph nodes, 42 of these were malignant (18%). TNBA-EBUS after neoadjuvant treatment showed persistence of N2 spread in 19 cases (52%). In negative cases (n=13; 41%) were performed mediastinoscopy (n=11) or surgery (n=1). After these procedures were confirmed mediastinal disease in 3 cases, 9 lymph nodes of 43 removed. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 86.4%, 100%, 100%, 72.7% and 90% respectively. There was recurrence of the disease in 15 cases (47%). We found a significant difference between recurrence and the type of neoadjuvant treatment (chemotherapy vs. radio-chemotherapy), p=0.047.
Table 1.
Conclusion
TBNA-EBUS is an appropriate semi-invasive tool in mediastinal restage after neoadjuvant treatment, with high diagnostic accuracy. Nevertheless, in negative cases is still necessary support with invasive procedures.
