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. © 2019 The Society of Thoracic Surgeons
Keywords: adult; controlled study; human tissue; aged; major clinical study; histopathology; cancer growth; outcome assessment; prospective study; sensitivity and specificity; computer assisted tomography; retrospective study; lung adenocarcinoma; needle biopsy; cancer classification; lung biopsy; human; male; female; priority journal; article
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
DOI: 10.1016/j.athoracsur.2019.03.043
PUBMED: 30986416
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 4 September 2019 -- Source: Scopus
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MSK Authors
  1. Majid Maybody
    76 Maybody
  2. William D Travis
    606 Travis
  3. Stephen Solomon
    302 Solomon
  4. Elena Nadia Petre
    58 Petre
  5. Jeremy Charles Durack
    94 Durack
  6. Tae-Hee Kim
    6 Kim
  7. Etay   Ziv
    39 Ziv