55P - Clinical significance of EBUS-TBNA in patients with small cell lung cancer

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Small-Cell Lung Cancer
Lung and other Thoracic Tumours
Presenter Young Min Lee
Citation Annals of Oncology (2017) 28 (suppl_2): ii17-ii20. 10.1093/annonc/mdx088
Authors Y.M. Lee
  • Pulmonary Medicine, Inje University Busan Paik Hospital, 47392 - Busan/KR

Abstract

Background

Small cell lung cancer (SCLC) is associated with rapid tumor growth and early dissemination. A mass in or adjacent to the hilum/mediastinum is particularly characteristic of SCLC. Transbronchial needle aspiration (TBNA) is minimally invasive and safe method for the evaluation of lung masses. The diagnostic sensitivity of TBNA is particularly high for SCLC (64-93%). The addition of endobronchial ultrasound (EBUS) guidance to TBNA (EBUS-TBNA) has greatly enhanced the diagnostic yield and safety of the procedure. The aim of this retrospective study was to assess the clinical characteristics of SCLC diagnosed by EBUS-TBNA and its clinical significance.

Methods

From January 2011 to December 2015, SCLC diagnosed by EBUS-TBNA were enrolled. For each patient, we documented patients characterisitics, size and locations of L/Ns, bronchoscopic findings and clinical courses. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA.

Results

A total of 100 patients (64[64%] with limited-stage and 36[36%] with extensive-stage disease) were included in this study. Sex and Age distribution was M: F = 92.8 with a mean age 66.3±16.2 years. The most common chief complains were cough (n = 51), dyspnea (n = 18), chest pain (n = 15), blood tinged sputum (n = 10) and hoarseness (n = 6). The majority of patients was smokers (n = 95, 95%) and heavy smoker (>40pack.yr) was 74 (74%). 26 patients (26%) had hilar/mediastinal masses without a primary parenchymal lesion. Tumor marker CEA mean value was 16.4 in LD and 27.6 in ED. In bronchoscopy findings, 79 (79%) cases show only bronchial obstruction by external compression. The median size of target lesion examined by EBUS-TBNA was 33mm (range 11.5-74mm). Of the 100 EBUS-TBNA samples, 100(100%) samples yielded a diagnosis of SCLC. The most common target lymph node was at station 4R, followed by 7 and 11R. The median number and duration of aspirates per lesion was 2 (range 1-5) and 13mins (10-33). The most common distatant metastasis organ was bone (n = 30), follow by liver (n = 15), adrenal gland (n = 7) and brain (n = 6). The most common comorbidity was COPD (n = 34) followed by Heart disease (n = 15) and DM (n = 13) and DILD (n = 7). 30 patients of SCLC were not received chemotherapy. In chemotherapy group, overall response rate was 78.5% (LD: 88%, ED: 55%). No procedure-related complications were noted.

Conclusions

EBUS-TBNA is a safe and highly accurate procedure for the diagnosis of SCLC. It is recommended a first diagnostic test if a patient is clinically suspected with SCLC.

Clinical trial identification

Legal entity responsible for the study

Busan Paik Hospital

Funding

Busan Paik Hospital

Disclosure

The author has declared no conflicts of interest.