Efficacy and safety in synchronous core-needle biopsy and cryoablation for highly suspicious malignant pulmonary nodule

TL;DR

This study compares the effectiveness and safety of doing a lung biopsy and cryoablation at the same time versus doing them separately for suspicious lung tumors.

Contribution

The study evaluates the efficacy and safety of synchronous versus sequential biopsy and cryoablation for pulmonary nodules.

Findings

Technical success rates were 100% in both synchronous and sequential groups.

Local tumor control was higher in the synchronous group (97%) compared to the sequential group (88%).

Abstract

Percutaneous computed tomography (CT)-guided biopsy and cryoablation are commonly used techniques for diagnosing and treating pulmonary malignant tumors. Performing these procedures simultaneously allows for tissue diagnosis while potentially offering therapeutic benefits. This study aimed to evaluate whether the efficacy and safety of simultaneous percutaneous CT-guided biopsy and cryoablation in managing pulmonary tumors suspected of malignancy are comparable to those of sequential procedures.

This retrospective study involved 124 patients with 131 highly suspicious malignant pulmonary nodules. Patients either underwent synchronous percutaneous core-needle biopsy and cryoablation (Group A) or separately underwent these procedures (Group B) from December 2020 to May 2024. All procedures were performed under CT guidance using a percutaneous approach. We analyzed technical success rates, complications, diagnostic yield, and local tumor control.

Technical success rates were 100% in both groups. The rate of pneumothorax was 42.1% (16/38) in Group A and 34.9% (30/86) in Group B. In Group A, hemoptysis and pleural effusion rates were 18.4% (7/38) and 23.7% (9/38), respectively, while in Group B, these rates were 16.3% (14/86) and 12.8% (11/86). These differences were not statistically significant. The diagnostic positive rate in Group A was 87.5%. The mean follow-up duration was 11.8 months (95% confidence interval [CI], 10.2–13.4), with local tumor control rates of 97% for Group A and 88% for Group B. The effectiveness rates of synchronous and separate procedures were similar.

Synchronous biopsy-ablation is an effective method for obtaining tumor pathology and local treatment of lung tumors simultaneously. It is a viable option for select patients where expedited diagnosis-therapy is clinically justified, particularly when molecular profiling is not immediately indicated.

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