1624P - “Liquid Withdarw” techniqueprominently reduced the incidence of pneumothorax and improved tumor tissue amount of CT-guided cutting needle lung biop...

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Staging procedures (clinical staging)
Thoracic malignancies
Basic Principles in the Management and Treatment (of cancer)
Presenter Rutian Li
Citation Annals of Oncology (2017) 28 (suppl_5): v568-v572. 10.1093/annonc/mdx389
Authors R. Li1, W. Ren1, J. Gao2, Y. Zhang3, P. Jiang1, X. Zhou1, H. Zhang2, X. Shen2, J. Liu1, S. Gao1, L. Wang1, B. Liu1
  • 1The Comprehensive Cancer Center Of Drum-tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, P.R. China, 210008 - Nanjing/CN
  • 2Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing P.R. China, 210008 - Nanjing/CN
  • 3Nanjing Drum Tower Hospital, Medical School of Southeast University, Nanjing P.R. China, 210008 - Nanjing/CN



CT-guided cutting needle lung biopsy is important for the diagnosis of lung cancer. In the area of precision medicine, it has become important to obtain adequate tumor tissue for the molecular testing. Pneumothorax is one of the most prevalent complications of the biopsy. In previous study, we found that “liquid withdraw” technique (to inject small amount of liquid durimng the withdrawal of the needle) can prominently reduce the incidence of pneumothorax. In this report, we retrospectively studied 92 CT-guided lung biopsy to investigate the role of this technique in reducing complications and promoting biopsy effevtiveness.


From Jan 1st, 2014 to Nov 30th, 2016, we retrospectively studied 92 CT-guided lung biopsy using liquid withdraw techniques in 90 patients. The pathologies (cytology, histology and EGFR mutation status) and complications secondary to biopsy procedure (pneumothorax, bleeding, etc.) were noted. Pneumothorax and bleeding was graded as mild (mild and very mild), moderate, and severe.


88 cases were diagnosed out of 92 biopsies (95.7%), of which 60 cases were adenocarcinoma. Among 52 cases of adenocarcinoma who consented EGFR mutation test, only 1 case (1.9%) was failed due to insufficient tissue. Among all the biopsies, when cutting tumor tissue 4-6 times per procedure, the incidence of pneumothorax was in 18 cases (19.6%), among which 13 cases (14.1%) were very mild pneumothorax (lung surface retraction of ≤ 1 cm), mild and moderate pneumothorax accounted for just 4.3%. No severe pneumothorax occurred. No other severe complications happened.


Compared to lung biopsy without liquid withdraw, the incidence of pneumothorax using “liquid withdraw technique” was reduced from approximately 35% to 19.6% (14.1% were very mild pneumothorax and 0% were severe pneumothorax). The liquid withdraw technique also resulted in low rate of other complications and adequate tissue for diagnosis and treatment planning of lung cancer. Next, we are planning to conduct a prospective study to further evaluate the role of liquid withdraw technique in the precision diagnosis and treatment of lung cancer.

Clinical trial identification

Legal entity responsible for the study

The Comprehensive Cancer Center of Drum-Tower Hospital, Medical School of Nanjing University


National Natural Science Foundation of China (81472216, 81672398)


All authors have declared no conflicts of interest.