157P - Mediastinal masses: A study of our cases by transthoracic needle biopsy (TTNB) versus open surgery as a diagnostic procedure

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter FADIL Gradica
Citation Annals of Oncology (2017) 28 (suppl_2): ii52-ii55. 10.1093/annonc/mdx094
Authors F. Gradica1, L. Lisha1, D. Argjiri2, A. Cani3, A. Leka4, F. Kokici3, S. Gradica5, Y. Vata6, F. Gradica5, V. Rexha5
  • 1Thoracic Surgery, University Hospital'Shefqet Ndroqi", 1000 - Tirane/AL
  • 2Pneumology, University Hospital'Shefqet Ndroqi", 1000 - Tirane/AL
  • 3Anestesie Reanimation, University Hospital'Shefqet Ndroqi", 1000 - Tirane/AL
  • 4Imagery, University Hospital'Shefqet Ndroqi", 1000 - Tirane/AL
  • 5Pharmacy Service, Pharmacy Public Service, 1000 - Tirane/AL
  • 6Visceral Surgery, University Hospital'Shefqet Ndroqi", 1000 - Tirane/AL

Abstract

Background

Mediastinal tumors are an uncommon abnormalities found in clinical practice. Transthoracic needle biopsy (TTNB) is done with imaging guidance and most frequently by a radiologist but and by a thoracic surgeon, for the aim is to diagnose a defined mass. It is integral in the diagnosis and treatment of many thoracic diseases, and is an important alternative to more invasive surgical procedures. Open biopsy is done by chamberlein procedures under general anesthesia.

Methods

We evaluate the different malignant mediastinal mass (MMs) in various age groups and the sensitivity and early mortality rate of open biopsy 2004 to 2013 and transthoracic needle biopsy (TTNB) and core needle biopsy (CNB) 2013-2016. This was a prospective study of 80 patients who were consulted for MMs and underwent open biopsy from 2004 to 2013 and 20 patients underwent by thoracic surgeon TTNB and CNB under guidance of ultrasound or computed tomography (CT) scan from 2013 to 2016. Cytology and histological examinations were evaluated in all patients.

Results

Among 80 cases, 63 were male and 17 were female were diagnosed by open biopsy from 2004 to 2013. Among 20 cases, 13 males and 7 females were diagnosed by TTNB. Mean age of presentation was 57 years old (ranging from 50-75 years old). Metastatic carcinoma and nonHodgkin's lymphoma are the common AMMs. Adequate tissue material by open biopsy was obtained in 80 cases and 17 of 20 cases (85%) by TTNB. Of these 17 patients, 15 (88,2%) cases were diagnosed correctly by TTNB, whereas 3 (11,8%) cases were not diagnosed definitely by TTNB. The sensitivity of TTNB for MMs was 85%, and no mortality whereas open biopsy were correctly diagnosed in 77 of 80 cases (96.25%) patients and operative mortality rate 2 patients (2.5%) and operative major compliactions in 3 (3.7%) patents had massive operative bleeding. Three cases (3.7%) had died after several mounths after open biopsy with out histological diagnosis. There is no significant difference of TTNB and open biopsy in carcinoma patients (P > 0.05). Operative mortality rate was higher for open biopsy in carcinomatous patients (3.7%) than for TTNB (0%).

Conclusions

CT scan-guided TTNB and CNB in combination with FNAC are safe, minimally invasive, and cost-effective procedure, with low morbitity rate and major complications, which can provide a precise diagnosis in the MMs, and may obviate the need for invasive surgical approach. Invasive surgical approach should be performed whenever the diagnosis by TTNB or CNB is suspected of carcinoma but not established.

Clinical trial identification

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Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.