Endoscopic Follow-up of Low Grade Precancerous Bronchial Lesions in High-Risk Patients: long-term results of the SELEPREBB randomized multicentre trial

International audienceBackground Three to 9% of low-grade pre-invasive bronchial lesions progress to cancer. This study assessed the usefulness of an intensive bronchoscopy surveillance strategy in patients with bronchial lesions up to moderate squamous dysplasia. Methods SELEPREBB ( NCT00213603 ) was a randomized study conducted in 17 French centers. After baseline lung CT-scan and autofluorescence bronchoscopy (AFB) excluding lung cancer and bronchial severe squamous dysplasia or carcinoma in situ (CIS), patients were assigned to standard surveillance (arm A) with CT and AFB at 36 months or to intensive surveillance (arm B) including AFB every 6 months. Further long term data were obtained with a median follow-up of 4.7 years. Results 364 patients were randomized (A: 180, B: 184). Twenty-seven patients developed invasive lung cancer and 2 developed persistent CIS during the study, without difference between arms (OR=0.63, 95% CI=[0.20–1.96], p=0.42). Mild or moderate dysplasia at baseline bronchoscopy was a significant lung cancer risk factor both at 3 years (8/74 patients, OR=6.9, 95% CI=[2.5–18.9], p