Is needle biopsy a risk factor of pleural recurrence after surgery for non-small cell lung cancer?

Preoperative computed tomography-guided needle biopsies (PCTGNBs) and intraoperative fine-needle aspiration biopsies (IFNABs) are valuable examinations for the evaluation of indeterminate pulmonary nodules with high accuracy and safety for the detection of malignancy (1-4), therefore they are important alternatives to trans-bronchial biopsies (TBBs) through bronchofiber scopes or surgical resection. However, several complications of PCTGNB and IFNAB have been reported, including tumor seeding and increasing the frequency of ipsilateral pleural recurrence (PR) (5-7). Although it is not conclusive whether such needle aspiration can be a potential hazard of PR, the two modalities are being applied in practice. On the other hand, PR with pleural dissemination or malignant effusion has sometimes been experienced in cases of pathologic stage IA lung cancer