Lung Lesions: Core is more for all.

Abstract

Introduction: Early and accurate diagnosis of lung cancer reduces morbidity and mortality regardless of age. This retrospective study aims to compare the outcomes of elderly patients (C 65 years) and younger patients (<65 years) undergoing radiologically guided core needle biopsy (CNB) and fine needle aspiration (FNA) of lung lesions. Method(s): Study analysis of 237 consecutive initial CNB and FNA performed between January 2007 and December 2013 in a large metropolitan tertiary health network. Specimens were sent for histopathological analysis. Post procedure imaging was performed to exclude complications. Result(s): Of the 155 elderly patients undergoing biopsy, 74% had CNB and 26% had FNA. 86 younger patients underwent biopsy with 72% CNB and 28% FNA. In both age groups, CNBs were performed more commonly on pleurally based lesions, whilst more FNAs were performed on non-pleurally based lesions. Malignancy was more common in the elderly, with more being identified by CNB (75%) than FNA (43%), compared to those aged younger (60% and 29% respectively). There was a higher rate of pneumothorax in the elderly (35% vs 24%) with a greater percentage requiring intervention. This was more common in biopsies of non-pleurally based lesions. Overall bleeding rates were similar in both groups for those undergoing CNB (8.7% vs 8.1%) with no documented haemorrhage in the elderly population undergoing FNA. Key conclusions: More elderly patients underwent biopsies of lung lesions compared to younger patients with a higher percentage of malignancy being diagnosed. Whilst they had a greater risk of pneumothorax, bleeding risk was comparable.