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Kuo SC, Lo YL, Chou CL, et al. Bronchoscopic debulking for endobronchial malignancy: Predictors of recanalization and recurrence. Thorac Cancer. 2015;6(6):722-30doi: 10.1111/1759-7714.12248.
Kuo, S. C., Lo, Y. L., Chou, C. L., Chung, F. T., Lin, S. M., Liu, C. Y., & Kuo, H. P. (2015). Bronchoscopic debulking for endobronchial malignancy: Predictors of recanalization and recurrence. Thoracic cancer, 6(6), 722-30. https://doi.org/10.1111/1759-7714.12248
Kuo, Scott Chih-Hsi, et al. "Bronchoscopic debulking for endobronchial malignancy: Predictors of recanalization and recurrence." Thoracic cancer vol. 6,6 (2015): 722-30. doi: https://doi.org/10.1111/1759-7714.12248
Kuo SC, Lo YL, Chou CL, Chung FT, Lin SM, Liu CY, Kuo HP. Bronchoscopic debulking for endobronchial malignancy: Predictors of recanalization and recurrence. Thorac Cancer. 2015 Nov;6(6):722-30. doi: 10.1111/1759-7714.12248. Epub 2015 Mar 16. PMID: 26557910; PMCID: PMC4632924.
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Thorac Cancer. 2015 Nov;6(6):722-30. doi: 10.1111/1759-7714.12248. Epub 2015 Mar 16.

Bronchoscopic debulking for endobronchial malignancy: Predictors of recanalization and recurrence.

Thoracic cancer

Scott Chih-Hsi Kuo, Yu-Lun Lo, Chun-Liang Chou, Fu-Tsai Chung, Shu-Min Lin, Chien-Ying Liu, Han-Pin Kuo

Affiliations

  1. Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University School of Medicine Taipei, Taiwan ; Department of Thoracic Medicine, Division of Oncology and Interventional Bronchoscopy, Chang Gung Memorial Hospital Taipei, Taiwan.
  2. Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University School of Medicine Taipei, Taiwan ; Department of Thoracic Medicine, Division of Airway Diseases, Chang Gung Memorial Hospital Taipei, Taiwan ; Healthcare Center, Chang Gung Memorial Hospital Taipei, Taiwan.
  3. Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University School of Medicine Taipei, Taiwan ; Department of Thoracic Medicine, Division of Airway Diseases, Chang Gung Memorial Hospital Taipei, Taiwan.

PMID: 26557910 PMCID: PMC4632924 DOI: 10.1111/1759-7714.12248

Abstract

BACKGROUND: Central airway obstruction related to endobronchial malignancy is one of the most difficult oncological complications and requires efficient palliative intervention.

METHODS: Fifty-three consecutive patients with unresectable endobronchial malignancy receiving bronchoscopic cryotherapy as palliative treatment were retrospectively reviewed. Efficiency was evaluated by the improvement of performance status (PS), and the best achievement of tumor removal was assessed as complete or partial removal.

RESULT: Patients' PS after cryotherapeutic tumor removal improved from the baseline PS (P = 0.006). In multivariate logistic regression analysis, the compression part of the tumor (odds ratio [OR] 0.42; 95% confidence interval [CI] 0.23∼0.75, P = 0.004) and the thin tumor stalk (OR 87.86; 95% CI 2.31∼3337.37, P = 0.016) were independent predictors of complete tumor removal. Tumors larger than 9.3 cm, including compression and invasion parts, had the highest odds of being only partially removed (positive predictive value [PPV]: 88.2%, likelihood ratio [LR]+: 10.49); tumors smaller than 9.3 cm were likely to be completely removed (negative predictive value [NPV]: 80.6%, LR-: 0.34). After cryotherapy, re-obstruction was significantly associated with non-squamous cell carcinoma (65.7 vs. 16.7%, P = 0.001) and patients who had longer overall survival (11.7 vs. 1.5 months, P < 0.001). Odds of tumor re-obstruction increased 2.28-fold (PPV: 81.6%, LR+: 2.28) beyond two months; the odds decreased by 81% (NPV: 73.3%, LR-: 0.19) within two months.

CONCLUSION: Debulking of a tumor using cryotherapy is a useful palliative treatment for endobronchial obstruction secondary to a variety of malignancies.

Keywords: Bronchoscopic; cryotherapy; endobronchial; malignancy

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