Transforming lung cancer diagnosis: the role of robotic-assisted bronchoscopy in early detection and staging.

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.