Feasibility and therapeutic implication of computed tomography-guided TruCut biopsy in cases of recurrent adenocarcinoma lung

Abstract

Author(s): Sagar Varotaria, Satya Sundar Gajendra Mohapatra, Adya Kinkar Panda, Soumya Surath Panda and Lalatendu Moharana*

Introduction: Recurrence is a rule, in the case of advanced NSCLC and even patients with early-stage disease are at risk of disease recurrence. It is recommended to acquire tissue biopsy samples at recurrence, not only for the diagnosis of relapsed disease but also for additional molecular analysis. TruCut biopsy is a simple procedure, is relatively safe, rapid and a reliable technique for the diagnosis of lung lesions. But all patients may not be ideal candidates for needle biopsy at recurrence because of various tumour related and patientrelated factors. This study of ours tried to find out the feasibility of image-guided transthoracic needle biopsy and compared its therapeutic implications with those who could not undergo the procedure.

Result: Overall adequacy rate of obtaining tissue samples was 89.7% (35/39). All patients who undergo needle biopsy tolerated it well. Most common complications were pneumothorax (12.8%) (5/39) and pulmonary haemorrhage (10.2%) (4/39). Two (5.1%) patients developed hydropneumothorax. The cumulative percentage of side effects was 17.9% (7/39) and no procedurerelated fatality. 42.8% of patients who underwent needle biopsy were started with the second line targeted/Immunotherapy. Only 21.0% of the patients who underwent liquid biopsy instead, received targeted therapy in the second line.

Conclusion: TruCut biopsies of NSCLC’S at recurrence are feasible and are adequate in appropriately selected patients and associated with acceptable rates of complications. Rebiopsy may explore new tumour characteristics and give the opportunity to act on changes in tumour behaviour. For those patients who are not candidates for a needle biopsy, in them, liquid biopsy is a comparable alternative.

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