Close surveillance with long-term follow-up of subjects with preinvasive endobronchial lesions

Rationale: Autofluorescence bronchoscopy (AFB) and computed tomography (CT) enable lung cancer (LC) detection at the early (pre-)invasive stage. However, LC risk in patients with preinvasive endobronchial lesions is unclear.Objectives: To assess LC incidence and identify potential risk determinants in patients with preinvasive lesions.Methods: In our tertiary care referral center, 164 subjects with preinvasive lesions were monitored up to 12.5 years by repeated AFB and CT. Occurrence of LC was monitored. Clinical management depended on histological grade, with cancer patients receiving standard care. Potential risk determinants (smoking status, baseline histology, cancer history, and chronic obstructive pulmonary disease [COPD] status) were evaluated in relation to cancer occurrence, event-free survival (EFS), and overall survival (OS).Measurements and Main Results: During surveillance (median of 30 mo, range 4–152) of 164 subjects with preinvasive lesions (80 high grade and 84 low grade at inclusion), 61...