Risk of Pleural Recurrence in Early Stage Lung Cancer Patients after Percutaneous Transthoracic Needle Biopsy: A Meta-analysis

Percutaneous transthoracic needle biopsies (PTNB) are widely used for the diagnosis of a peripheral pulmonary nodules, but the risk of pleural recurrence in lung cancer patients remains undetermined. Our meta-analysis aims to answer the question whether PTNB strategy increases the risk of recurrence. PubMed, EMBASE, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched from inception to January 9, 2016. A total of 1242 patients from 5 studies were included. The results showed that PTNB does not increase risk of total recurrence (Odds Ratio,0.78; 95% CI, 0.53 to 1.15) or pleural recurrence (Odds Ratio,1.58; 95% CI, 0.41 to 6.12) compared with non-PTNB strategies in early stage lung cancer patients. Subgroup analysis showed that PTNB was associated with increased pleural recurrence (Odds Ratio, 10.76; 95% CI, 2.92 to 39.70) in patients with sub-pleural lesions but not in patients without sub-pleural lesions (Odds Ratio, 0.96; 95% CI, 0.24 to 3.89). In conclusion, PTNB should not be recommended in lung cancer patients with sub-pleural lesions. However, PTNB is recommendable to use in other patients without sub-pleural lesions to whom pathological diagnosis is necessary, especially in patients with relevant comorbidities.