Skip to main content
Erschienen in: Surgery Today 3/2021

17.08.2020 | Original Article

Endobronchial ultrasound-guided transbronchial needle aspiration in patients with previously treated lung cancer

verfasst von: Taiki Fujiwara, Takahiro Nakajima, Terunaga Inage, Yuki Sata, Takayoshi Yamamoto, Yuichi Sakairi, Hironobu Wada, Hidemi Suzuki, Masako Chiyo, Ichiro Yoshino

Erschienen in: Surgery Today | Ausgabe 3/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The sampling and accurate diagnosis of lymph nodes during the clinical history of lung cancer are essential for selecting the appropriate treatment strategies. This study aims to evaluate the feasibility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with previously treated lung cancer.

Methods

Patients who underwent EBUS-TBNA after treatment for lung cancer were retrospectively reviewed. We classified the patients into two groups; Group 1 (G1): Indicated to have a recurrence of new lesions after radical surgery or chemo/radiotherapy with a curative intent; and Group 2 (G2): Indicated to have residual tumor cells after undergoing primary treatment for chemo/radiotherapy or re-staging after induction therapy prior to surgery.

Results

Seventy previously treated lung cancer cases (G1, n = 52; G2, n = 18) were enrolled. Thirty-two cases (61.5%) had recurrent disease in G1, and 9 cases (50.0%) had nodal metastasis in G2. The diagnostic accuracy was 95.2% in G1 and 88.9% in G2. Twenty-four cases were examined for epidermal growth factor receptor (EGFR) mutations, and 9 (37.5%) cases had mutations, including two cases with a T790M mutation. Furthermore, in one case, a re-biopsy revealed that the initial adenocarcinoma had transformed into small cell lung cancer.

Conclusion

Performing EBUS-TBNA during lung cancer treatment showed a high diagnostic yield. Samples obtained by EBUS-TBNA were helpful in determining when to perform repeat biomarker testing as well as for making pathological re-evaluations.
Literatur
1.
Zurück zum Zitat Reck M, Rabe KF. Precision diagnosis and treatment for advanced non-small-cell lung cancer. N Engl J Med. 2017;377:849–61.CrossRef Reck M, Rabe KF. Precision diagnosis and treatment for advanced non-small-cell lung cancer. N Engl J Med. 2017;377:849–61.CrossRef
2.
Zurück zum Zitat Sakata KK, Midthun DE, Mullon JJ, Kern RM, Nelson DR, Edell ES, Schiavo DN, Jett JR, Aubry MC. Comparison of programmed death ligand-1 immunohistochemical staining between endobronchial ultrasound transbronchial needle aspiration and resected lung cancer specimens. Chest. 2018;154:827–37.CrossRef Sakata KK, Midthun DE, Mullon JJ, Kern RM, Nelson DR, Edell ES, Schiavo DN, Jett JR, Aubry MC. Comparison of programmed death ligand-1 immunohistochemical staining between endobronchial ultrasound transbronchial needle aspiration and resected lung cancer specimens. Chest. 2018;154:827–37.CrossRef
3.
Zurück zum Zitat Yoshimura K, Inoue Y, Karayama M, Tsuchiya K, Mori K, Suzuki Y, Iwashita Y, Kahyo T, Kawase A, Tanahashi M, Ogawa H, Yokomura K, Inui N, Funai K, Shinmura K, Niwa H, Suda T, Sugimura H. Heterogeneity analysis of PD-L1 expression and copy number status in EBUS-TBNA biopsy specimens of non-small cell lung cancer: comparative assessment of primary and metastatic sites. Lung Cancer. 2019;134:202–9.CrossRef Yoshimura K, Inoue Y, Karayama M, Tsuchiya K, Mori K, Suzuki Y, Iwashita Y, Kahyo T, Kawase A, Tanahashi M, Ogawa H, Yokomura K, Inui N, Funai K, Shinmura K, Niwa H, Suda T, Sugimura H. Heterogeneity analysis of PD-L1 expression and copy number status in EBUS-TBNA biopsy specimens of non-small cell lung cancer: comparative assessment of primary and metastatic sites. Lung Cancer. 2019;134:202–9.CrossRef
4.
Zurück zum Zitat Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K, Iizasa T, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest. 2004;126:122–8.CrossRef Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K, Iizasa T, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest. 2004;126:122–8.CrossRef
5.
Zurück zum Zitat Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and metaanalysis. Eur J Cancer. 2009;45:1389–96.CrossRef Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and metaanalysis. Eur J Cancer. 2009;45:1389–96.CrossRef
6.
Zurück zum Zitat Adams K, Shah PL, Edmonds L, Lim E. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax. 2009;64:757–62.CrossRef Adams K, Shah PL, Edmonds L, Lim E. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax. 2009;64:757–62.CrossRef
7.
Zurück zum Zitat Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer. Diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2013;143:e211S–e250S250S. https://doi.org/10.1378/chest.12-2355.CrossRefPubMed Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer. Diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2013;143:e211S–e250S250S. https://​doi.​org/​10.​1378/​chest.​12-2355.CrossRefPubMed
8.
Zurück zum Zitat Shingyoji M, Nakajima T, Nishimura H, Ishikawa A, Itakura M, Kaji S, et al. Restaging by endobronchial ultrasound-guided transbronchial needle aspiration in patients with inoperable advanced lung cancer. Intern Med. 2010;49:787–90.CrossRef Shingyoji M, Nakajima T, Nishimura H, Ishikawa A, Itakura M, Kaji S, et al. Restaging by endobronchial ultrasound-guided transbronchial needle aspiration in patients with inoperable advanced lung cancer. Intern Med. 2010;49:787–90.CrossRef
9.
Zurück zum Zitat Anraku M, Pierre AF, Nakajima T, de Perrot M, Darling GE, Waddell TK, et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the management of previously treated lung cancer. Ann Thorac Surg. 2011;92:251–5.CrossRef Anraku M, Pierre AF, Nakajima T, de Perrot M, Darling GE, Waddell TK, et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the management of previously treated lung cancer. Ann Thorac Surg. 2011;92:251–5.CrossRef
10.
Zurück zum Zitat Szlubowski A, Zieliński M, Soja J, Filarecka A, Orzechowski S, Pankowski J, et al. Accurate and safe mediastinal restaging by combined endobronchial and endoscopic ultrasound-guided needle aspiration performed by single ultrasound bronchoscope. Eur J Cardiothorac Surg. 2014;46:262–6.CrossRef Szlubowski A, Zieliński M, Soja J, Filarecka A, Orzechowski S, Pankowski J, et al. Accurate and safe mediastinal restaging by combined endobronchial and endoscopic ultrasound-guided needle aspiration performed by single ultrasound bronchoscope. Eur J Cardiothorac Surg. 2014;46:262–6.CrossRef
11.
Zurück zum Zitat Herth FJ, Annema JT, Eberhardt R, Yasufuku K, Ernst A, Krasnik M, et al. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer. J Clin Oncol. 2008;26:3346–50.CrossRef Herth FJ, Annema JT, Eberhardt R, Yasufuku K, Ernst A, Krasnik M, et al. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer. J Clin Oncol. 2008;26:3346–50.CrossRef
12.
Zurück zum Zitat Szlubowski A, Herth FJ, Soja J, Kołodziej M, Figura J, Cmiel A, et al. Endobronchial ultrasound-guided needle aspiration in non-small-cell lung cancer restaging verified by the transcervical bilateral extended mediastinal lymphadenectomy–a prospective study. Eur J Cardiothorac Surg. 2010;37:1180–4.CrossRef Szlubowski A, Herth FJ, Soja J, Kołodziej M, Figura J, Cmiel A, et al. Endobronchial ultrasound-guided needle aspiration in non-small-cell lung cancer restaging verified by the transcervical bilateral extended mediastinal lymphadenectomy–a prospective study. Eur J Cardiothorac Surg. 2010;37:1180–4.CrossRef
13.
Zurück zum Zitat Sanz-Santos J, Serra P, Andreo F, Torky M, Centeno C, Morán T, et al. Transbronchial and transesophageal fine-needle aspiration using a single ultrasound bronchoscope in the diagnosis of locoregional recurrence of surgically-treated lung cancer. BMC Pulm Med. 2017;17:46.CrossRef Sanz-Santos J, Serra P, Andreo F, Torky M, Centeno C, Morán T, et al. Transbronchial and transesophageal fine-needle aspiration using a single ultrasound bronchoscope in the diagnosis of locoregional recurrence of surgically-treated lung cancer. BMC Pulm Med. 2017;17:46.CrossRef
14.
Zurück zum Zitat Guarize J, Casiraghi M, Donghi S, Casadio C, Diotti C, Filippi N, et al. EBUS-TBNA in PET-positive lymphadenopathies in treated cancer patients. ERJ Open Res. 2017;3(4):00009–2017.CrossRef Guarize J, Casiraghi M, Donghi S, Casadio C, Diotti C, Filippi N, et al. EBUS-TBNA in PET-positive lymphadenopathies in treated cancer patients. ERJ Open Res. 2017;3(4):00009–2017.CrossRef
15.
Zurück zum Zitat Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P, MembersofIASLCStagingCommittee. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4(5):568–77.CrossRef Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P, MembersofIASLCStagingCommittee. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4(5):568–77.CrossRef
16.
Zurück zum Zitat Fujiwara T, Yasufuku K, Nakajima T, Chiyo M, Yoshida S, Suzuki M, et al. The utility of sonographic features during endobronchial ultrasound-guided transbronchial needle aspiration for lymph node staging in patients with lung cancer: a standard endobronchial ultrasound image classification system. Chest. 2010;138:641–7.CrossRef Fujiwara T, Yasufuku K, Nakajima T, Chiyo M, Yoshida S, Suzuki M, et al. The utility of sonographic features during endobronchial ultrasound-guided transbronchial needle aspiration for lymph node staging in patients with lung cancer: a standard endobronchial ultrasound image classification system. Chest. 2010;138:641–7.CrossRef
17.
Zurück zum Zitat Nakajima T, Yasufuku K, Saegusa F, Fujiwara T, Sakairi Y, Hiroshima K, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in patients with lung cancer. Ann Thorac Surg. 2013;95:1695–9.CrossRef Nakajima T, Yasufuku K, Saegusa F, Fujiwara T, Sakairi Y, Hiroshima K, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in patients with lung cancer. Ann Thorac Surg. 2013;95:1695–9.CrossRef
18.
Zurück zum Zitat Lee HS, Lee GK, Lee HS, Kim MS, Lee JM, Kim HY, Nam BH, Zo JI, Hwangbo B. Real-time endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal staging of non-small cell lung cancer: how many aspirations per target lymph node station? Chest. 2009;135:1280–7.CrossRef Lee HS, Lee GK, Lee HS, Kim MS, Lee JM, Kim HY, Nam BH, Zo JI, Hwangbo B. Real-time endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal staging of non-small cell lung cancer: how many aspirations per target lymph node station? Chest. 2009;135:1280–7.CrossRef
19.
Zurück zum Zitat Nakajima T, Yasufuku K, Suzuki M, Fujiwara T, Shibuya K, Takiguchi Y, et al. Assessment of epidermal growth factor receptor mutation by endobronchial ultrasound-guided transbronchial needle aspiration. Chest. 2007;132:597–602.CrossRef Nakajima T, Yasufuku K, Suzuki M, Fujiwara T, Shibuya K, Takiguchi Y, et al. Assessment of epidermal growth factor receptor mutation by endobronchial ultrasound-guided transbronchial needle aspiration. Chest. 2007;132:597–602.CrossRef
20.
Zurück zum Zitat Sakairi Y, Nakajima T, Yasufuku K, Ikebe D, Kageyama H, Soda M, et al. EML4-ALK fusion gene assessment using metastatic lymph node samples obtained by endobronchial ultrasound-guided transbronchial needle aspiration. Clin Cancer Res. 2010;16:4938–45.CrossRef Sakairi Y, Nakajima T, Yasufuku K, Ikebe D, Kageyama H, Soda M, et al. EML4-ALK fusion gene assessment using metastatic lymph node samples obtained by endobronchial ultrasound-guided transbronchial needle aspiration. Clin Cancer Res. 2010;16:4938–45.CrossRef
21.
Zurück zum Zitat Sakakibara R, Inamura K, Tambo Y, Ninomiya H, Kitazono S, Yanagitani N, et al. EBUS-TBNA as a Promising Method for the Evaluation of Tumor PD-L1 Expression in Lung Cancer. Clin Lung Cancer. 2017;18:527–34.CrossRef Sakakibara R, Inamura K, Tambo Y, Ninomiya H, Kitazono S, Yanagitani N, et al. EBUS-TBNA as a Promising Method for the Evaluation of Tumor PD-L1 Expression in Lung Cancer. Clin Lung Cancer. 2017;18:527–34.CrossRef
Metadaten
Titel
Endobronchial ultrasound-guided transbronchial needle aspiration in patients with previously treated lung cancer
verfasst von
Taiki Fujiwara
Takahiro Nakajima
Terunaga Inage
Yuki Sata
Takayoshi Yamamoto
Yuichi Sakairi
Hironobu Wada
Hidemi Suzuki
Masako Chiyo
Ichiro Yoshino
Publikationsdatum
17.08.2020
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 3/2021
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02101-8

Weitere Artikel der Ausgabe 3/2021

Surgery Today 3/2021 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.