title: Risk of pleural recurrence after needle biopsy in patients with resected early stage lung cancer.
abstract: BACKGROUND
  Concerning the complications resulting from percutaneous needle biopsy (PNB), although cases of tumor seeding into the needle track have occasionally been reported, there were only two cases of pleural recurrences to date. The aim of this study was to elucidate the real risk of pleural recurrence after needle biopsy in patients with resected early stage lung cancer.
  
  
  METHODS
  Between 1986 and 2000, 335 patients with stage I nonsmall cell lung cancer underwent complete resection of the lung tumor. We retrospectively reviewed their medical records and investigated the relationship between the diagnostic methods used and the cancer recurrence patterns.
  
  
  RESULTS
  Preoperative diagnoses were obtained for 290 patients; 220 were diagnosed by bronchoscopy and 66 by PNB. Among the patients without a preoperative diagnosis, 27 were diagnosed by intraoperative needle biopsy and 14 by wedge resection of the lung. Tumors diagnosed by needle biopsy including PNB and intraoperative needle biopsy were smaller and showed less vessel invasion than those diagnosed by other methods (p < 0.01). After surgical resection, 9 patients had pleural recurrence and 1 patient, needle track implantation. Seven of these 10 patients were diagnosed by needle biopsy using 18G cutting type needle. Pleural recurrence or needle track implantation was observed for 8.6% of the patients who underwent a needle biopsy, whereas it was 0.9% for patients who were examined using other diagnostic modalities (p = 0.0009).
  
  
  CONCLUSIONS
  Needle biopsy especially using a cutting-type biopsy needle can cause a pleural recurrence in addition to needle track implantation.
authors.affiliation: Division of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan. hmatsugu@tcc.pref.tochigi.jp
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Matsuguma
authors.forename: Rie
authors.initials: R
authors.lastname: Nakahara
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kondo
authors.forename: Yukari
authors.initials: Y
authors.lastname: Kamiyama
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mori
authors.forename: Kohei
authors.initials: K
authors.lastname: Yokoi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000453:epidemiology* / Q000556:secondary*; D012189:Retrospective Studies; D012307:Risk Factors