ArticleJournal of thoracic disease2026
Preoperative percutaneous transthoracic needle biopsy and pleural recurrence after curative resection for stage I non-small cell lung cancer: a systematic review and meta-analysis.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
Background: Whether preoperative percutaneous transthoracic needle biopsy (PTNB) increases postoperative pleural recurrence after curative resection for stage I non-small cell lung cancer (NSCLC) remains controversial, particularly for lesions abutting the pleura. It is aimed to quantify the association between preoperative PTNB and pleural recurrence after resection for stage I NSCLC, and to evaluate whether subpleural tumor location modifies this association. Methods: We performed a systematic review and meta-analysis of comparative cohort studies evaluating pleural recurrence after curative resection in patients with stage I NSCLC who underwent preoperative PTNB versus those who did not. Binary pleural recurrence was pooled using DerSimonian-Laird random-effects models. Prespecified subgroup analyses examined subpleural and non-subpleural lesions. Cox hazard ratios (HRs) and Fine-Gray subdistribution hazard ratios (sHRs) were synthesized separately. Results: Nine comparative cohorts were eligible for qualitative synthesis. Eight cohorts (total N=3,531; PTNB n=1,621; no-PTNB n=1,910) contributed to the primary binary synthesis. PTNB was associated with higher pleural recurrence [pooled risk ratio (RR) 2.15, 95% confidence interval (CI): 1.17-3.94; I Conclusions: In resected stage I NSCLC, the binary synthesis suggests an association between preoperative PTNB and higher postoperative pleural recurrence, with the strongest signal in subpleural tumors. However, time-to-event estimates were limited and imprecise. Therefore, they should be interpreted cautiously given the observational study designs. Diagnostic pathways for pleura-abutting nodules should therefore be individualized, and future studies should prospectively capture needle-tract variables and competing-risk outcomes.
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