Diagnostic procedures and related complications for subsolid nodules detected at baseline and follow-up screening
| Total (n=293) | Baseline subsolid nodule (n=266) | New subsolid nodule (n=27) | P value* | |
| Time of biopsy, n (%) | 0.793 | |||
| At first detection | 49 (16.7) | 44 (16.5) | 5 (18.5) | |
| After follow-up | 244 (83.3) | 222 (83.5) | 22 (81.5) | |
| Time from first detection to biopsy (months), mean±SD | 29.8±39.4 | 30.1±39.7 | 26.7±37.1 | 0.651 |
| Type of initial biopsy for diagnosis, n (%) | 0.267 | |||
| Video-assisted thoracic surgery | 258 (88.1) | 236 (88.7) | 22 (81.5) | |
| Percutaneous needle biopsy | 30 (10.2) | 25 (9.4) | 5 (18.5) | |
| Bronchoscopy-guided biopsy | 5 (1.7) | 5 (1.9) | 0 (0) | |
| Range of surgical resection, n/N (%)† | 0.249 | |||
| Lobectomy | 146/276 (52.9) | 136/252 (54.0) | 10/24 (41.7) | |
| Segmentectomy or wedge resection | 130/276 (47.1) | 116/252 (46.0) | 14/24 (58.3) | |
| Required rebiopsy for insufficient diagnosis, n (%) | 2 (0.7) | 2 (0.8) | 0 (0) | 1.000 |
| Complications related to invasive biopsy, n (%) | – | |||
| Pneumothorax requiring pleurodesis | 23 (7.8) | 22 (8.3) | 1 (3.7) | |
| Postoperative pneumonia | 3 (1.0) | 3 (1.1) | 0 (0) | |
| Bleeding requiring additional intervention | 2 (0.7) | 2 (0.8) | 0 (0) | |
| Pulmonary thromboembolism | 1 (0.3) | 1 (0.4) | 0 (0) | |
| Vocal cord palsy | 1 0.3) | 1 (0.4) | 0 (0) | |
| Chylothorax | 7 (2.4) | 7 (2.6) | 0 (0) | |
| Bronchial stenosis | 1 (0.3) | 1 (0.4) | 0 (0) | |
| Persistent pleural effusion | 5 (1.7) | 5 (1.9) | 0 (0) | |
| Acute coronary syndrome or stroke | 1 (0.3) | 0 (0) | 1 (3.7) | |
| Diagnosed as lung cancer, n (%) | 227 (77.5) | 210 (78.9) | 17 (63.0) | 0.058 |
| Diagnosed as benign (false-positive), n (%) | 65 (22.2) | 55 (20.7) | 10 (37.0) | 0.051 |
| Pathological diagnosis of benign nodule, n/N (%) | 0.009 | |||
| AAH | 34/65 (52.3) | 32/55 (58.2) | 2/10 (20.0) | |
| Focal fibrosis | 9/65 (13.8) | 9/55 (16.4) | 0/10 (0) | |
| Inflammatory nodule‡ | 17/65 (26.2) | 11/55 (20.0) | 6/10 (60.0) | |
| Other benign condition§ | 5/65 (7.7) | 3/55 (5.5) | 2/10 (20.0) |
*The p value is based on the comparison between baseline and new nodules.
†All nodules resected for diagnosis or treatment underwent video-assisted thoracic surgery with the exception of one case that converted to open thoracotomy during video-assisted thoracic surgery due to uncontrolled bleeding.
‡Including chronic inflammation and infectious nodules.
§Including nodules related with cryptogenic organising pneumonia, vasculitis, IgG4 disease and placental transmogrification.
AAH, atypical adenomatous hyperplasia.