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  3. Is histological confirmation necessary to avoid futile resections? Comparative of four university hospitals.

Is histological confirmation necessary to avoid futile resections? Comparative of four university hospitals.

Fecha de publicación: Fecha Ahead of Print:

Autores de IDIVAL

  • Laura Sánchez Moreno

    Autor

Autores ajenos al IDIVAL

  • Aguinagalde B
  • Lizarbe IA
  • Rumbero JC
  • Lorenzo M
  • Sanchez L
  • Fernández-Monge A
  • Lopez I

Unidades

Abstract

OBJECTIVES: There is no consensus in the literature on preoperative histological analysis for lung cancer. The objective of this study was to assess four diagnostic models used in different hospitals with differing practices regarding preoperative histological diagnosis and the consequences in terms of unnecessary surgery and futile major resection. METHODS: We carried out a retrospective observational study collected from four university hospitals in Spain over 3 years (January 2019 to December 2021). We included all patients with a confirmed diagnosis of primary lung cancer and any patients with suspected primary lung cancer who had undergone surgery. All patients underwent CT and PET/CT scans. Each multidisciplinary committee was free to choose whether to perform flexible bronchoscopic or transthoracic lung biopsy. Decisions concerning whether to perform intraoperative sample analysis, the surgical approach and the type of resection were left to the surgical team. RESULTS: We included a total of 1642 patients. The use of flexible endoscopy and its diagnostic performance varied substantially between hospitals (range: 23.8%-79.3% and 25%-60.7%, respectively); and the same was observed for transthoracic biopsy and its performance (range: 16.9%-82.3% and 64.6%-97%, respectively). Regarding major resection surgery (lobectomy or more extensive resection), the lowest rate was observed in hospital C (1%) and the highest in hospital B (2.8%), with between-hospital differences not reaching significance (p = 0.173). CONCLUSIONS: The rate of histological sampling before lung cancer surgery still varies between hospitals. In spite of very diverse multidisciplinary management, the rate of futile lobectomy is not significantly higher in hospitals with lower rates of preoperative histological analysis.

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
1010-7940, 1873-734X

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY  OXFORD UNIV PRESS INC

Tipo:
Article
Páginas:
-
PubMed:
38632054

Citas Recibidas en Web of Science: 1

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Keywords

  • Lung cancer; Lung cancer diagnosis; lung cáncer surgery; preoperative histological confirmation

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