Postoperative fluorescence bronchoscopic surveillance in non-small cell lung cancer patients

Ann Thorac Surg. 2001 Mar;71(3):967-70. doi: 10.1016/s0003-4975(00)02523-6.


Background: Second lung primaries occur at a rate of 1% to 3% per patient-year after complete resections for non-small cell lung carcinoma (NSCLC). Fluorescence bronchoscopy appears to be a sensitive tool for surveillance of the tracheobronchial tree for early neoplasias.

Methods: Patients who were disease-free after complete resection of a NSCLC were entered into a fluorescence bronchoscopy surveillance program. All suspicious lesions were biopsied along with two areas of normal mucosa to serve as negative controls.

Results: A total of 73 fluorescence bronchoscopies were performed after conventional bronchoscopy in 51 patients at a median of 13 months postresection. The majority (46 of 51) of patients had stage I or II NSCLC, whereas 10% (5 of 51) had stage IIIA. Three intraepithelial neoplasias and one invasive carcinoma were identified in 3 of 51 patients (6%), all current or former smokers. Of the four lesions identified, three were in the 20 patients with prior squamous cell carcinomas. No intraepithelial neoplasias were identified by white-light bronchoscopy, whereas two of three were detected by fluorescence examination. The one invasive cancer detected was apparent on both white-light and fluorescence bronchoscopic examinations.

Conclusions: Surveillance with fluorescence bronchoscopy identified lesions in 6% of postoperative NSCLC patients thought to be disease-free. Patients with prior squamous cell carcinomas appear to be a population that may warrant future prospective study of postoperative fluorescence bronchoscopic surveillance.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchoscopy / methods*
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Female
  • Fluorescence
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / diagnosis*
  • Population Surveillance
  • Postoperative Care*