Lung cancer (Amsterdam, Netherlands) · 2025
Transforming lung cancer diagnosis: the role of robotic-assisted bronchoscopy in early detection and staging.
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Fernandez-Bussy Sebastian, Funes-Ferrada Rodrigo, Yu Lee-Mateus Alejandra, Vaca-Cartagena Bryan F, Barrios-Ruiz Alanna, Valdes-Camacho Sofia, Patel Neal M, Husta Bryan C, Hazelett Britney N, Ibrahim Mohamed I, Robertson Kelly S, Chadha Ryan M, Abia-Trujillo David
Аннотация
INTRODUCTION: Minimally invasive techniques, including CT-guided transthoracic biopsy (CTTB) and robotic-assisted bronchoscopy (RAB), play a crucial role in diagnosing peripheral pulmonary lesions suspected of lung cancer. This article aims to assess differences in primary lung cancer diagnosis and staging between patients undergoing ssRAB with shape-sensing RAB (ssRAB) and CTTB.
METHODS: This retrospective cohort study included 407 patients who underwent CTTB (2017-2020) and 556 who underwent ssRAB (2020-2023) at a single institution. Propensity score matching (1:1) was applied to balance baseline covariates. Outcomes included cancer stage at diagnosis, procedural safety, and hospital metrics. Logistic regression and descriptive statistics were used to analyze differences.
RESULTS: After matching, 148 patients per group were analyzed. Patients in the ssRAB group were more frequently diagnosed at an early stage compared to the CTTB group (OR = 3.02, 95 % CI: 1.83-5.04, p < 0.001). ssRAB demonstrated significantly lower rates of pneumothorax (3.38 % vs. 44.59 %, p < 0.001) and hospital admissions (5.41 % vs. 19.59 %, p < 0.001). Despite longer procedural times, ssRAB reduced hospital stays by 34 min (p < 0.001). Diagnostic yield for malignancy was comparable between ssRAB and CTTB (86.48 % vs. 89.18 %, p = 0.594).
CONCLUSION: ssRAB significantly improves early-stage lung cancer detection and reduces procedural risks, offering a safer, patient-centered approach. Its integration into diagnostic pathways represents a transformative advancement in lung cancer care. Further studies are warranted to confirm its broader impact across diverse healthcare settings.
METHODS: This retrospective cohort study included 407 patients who underwent CTTB (2017-2020) and 556 who underwent ssRAB (2020-2023) at a single institution. Propensity score matching (1:1) was applied to balance baseline covariates. Outcomes included cancer stage at diagnosis, procedural safety, and hospital metrics. Logistic regression and descriptive statistics were used to analyze differences.
RESULTS: After matching, 148 patients per group were analyzed. Patients in the ssRAB group were more frequently diagnosed at an early stage compared to the CTTB group (OR = 3.02, 95 % CI: 1.83-5.04, p < 0.001). ssRAB demonstrated significantly lower rates of pneumothorax (3.38 % vs. 44.59 %, p < 0.001) and hospital admissions (5.41 % vs. 19.59 %, p < 0.001). Despite longer procedural times, ssRAB reduced hospital stays by 34 min (p < 0.001). Diagnostic yield for malignancy was comparable between ssRAB and CTTB (86.48 % vs. 89.18 %, p = 0.594).
CONCLUSION: ssRAB significantly improves early-stage lung cancer detection and reduces procedural risks, offering a safer, patient-centered approach. Its integration into diagnostic pathways represents a transformative advancement in lung cancer care. Further studies are warranted to confirm its broader impact across diverse healthcare settings.