Utility of core biopsy specimen to identify histologic subtype and predict outcome for lung adenocarcinoma Journal Article

Authors: Kim, T. H.; Buonocore, D.; Petre, E. N.; Durack, J. C.; Maybody, M.; Johnson, R. P.; Travis, W. D.; Adusumilli, P. S.; Solomon, S. B.; Ziv, E.
Article Title: Utility of core biopsy specimen to identify histologic subtype and predict outcome for lung adenocarcinoma
Abstract: Background. Lung adenocarcinoma histologic subtype is an important indicator of patient outcomes, so preoperative knowledge of subtype may be helpful to guide surgical planning. We evaluated the sensitivity and prognostic efficacy of specimens from computed tomography-guided core needle biopsies to predict histologic subtype and patient outcome after surgery. Methods. We retrospectively identified 221 patients with lung adenocarcinoma who underwent computed tomography-guided lung biopsy and subsequent surgical resection. Concordance, accuracy, specificity, and sensitivity of histologic subtypes from core biopsy specimens were compared with surgically resected specimens. Tumor characteristics and biopsy procedural factors were analyzed to determine impact on diagnostic sensitivity. Histologic subtype based on biopsy specimen, clinical, tumor, and treatment variables were also examined in relation to time to progression. Results. Overall concordance of biopsy samples with the predominant subtype from surgical specimens was 77%. Specificity (sensitivity) of detecting a nonaggressive and aggressive subtype were 86% (93%) and 95% (48%), respectively. Length of core specimen and percentage subtype composition in the surgically resected specimen were correlated with improved sensitivity but to a lesser extent with aggressive subtypes. Presence of an aggressive subtype in biopsy specimens was an independent predictor of progression after surgery (subdistribution hazard ratio, 2.51; 95% confidence interval, 1.28-4.94; p = 0.0075). Conclusions. Specimens from computed tomography-guided core biopsies can predict lung adenocarcinoma progression after surgical resection. Future prospective studies should address the role of core biopsy in preoperative planning. (C) 2019 by The Society of Thoracic Surgeons
Keywords: classification; recurrence; impact; micropapillary; pattern; international association
Journal Title: Annals of Thoracic Surgery
Volume: 108
Issue: 2
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2019-08-01
Start Page: 392
End Page: 398
Language: English
ACCESSION: WOS:000476514900036
DOI: 10.1016/j.athoracsur.2019.03.043
PUBMED: 30986416
Notes: Article -- Source: Wos
Altmetric Score
MSK Authors
  1. Majid Maybody
    73 Maybody
  2. William D Travis
    556 Travis
  3. Stephen Solomon
    273 Solomon
  4. Elena Nadia Petre
    51 Petre
  5. Jeremy Charles Durack
    89 Durack
  6. Tae-Hee Kim
    6 Kim
  7. Etay   Ziv
    29 Ziv