Background: Bronchoscopy and endobronchial ultrasound (EBUS) are standard procedures for the diagnosis and staging of patients suspected of lung cancer. If the patient simultaneously presents with suspicious liver lesions, it is tradition to refer the patient to a radiologist for ultrasound-guided percutaneous liver biopsy. Objective: The aim of this study was to investigate the results and complications when the pulmonologist performs all three procedures in the same setting. Methods: We retrospectively identified patients who during 2018–2020 underwent invasive workup of suspected lung cancer and liver metastases with percutaneous liver lesion biopsy with or without same-day endoscopy (bronchoscopy and EBUS). We compared diagnostic yield and safety of liver lesion biopsy stratified by same-day endoscopy or not. Results: In total, 89 patients were included, of whom 28 patients (31%) underwent same-day endoscopy. All liver lesion biopsies were fine-needle aspiration biopsies performed by experienced pulmonologists. No complications were reported, and overall diagnostic yield was 88%. The diagnostic yield was significantly lower in the same-day endoscopy group (71% vs. 95%), and undergoing endoscopy was significantly associated with having fewer liver lesions, higher prevalence of lung cancer, and lower overall prevalence of a malignant diagnosis. Conclusion: Liver biopsy in the same session as endoscopy during lung cancer workup was feasible and safe. Confounding by indication was present in our study.

Background: Recurrent malignant pleural effusion is treated with talc pleurodesis or indwelling pleural catheters. We aimed to identify biochemical fluid biomarkers to predict treatment response. Methods: We performed a strict literature search in PubMed and checked reference lists in relevant clinical studies and in identified review papers. Studies on the added value of biochemical fluid biomarkers to clinical variables such as pleural effusion lactate dehydrogenase (pLDH), pleural fluid LDH, pleural fluid glucose, pleural fluid pH were of special interest. Results: We identified 11 studies (total n = 1466 patients), all on pleurodesis with talc or doxycycline. Pleural effusion lactate dehydrogenase >300 IU/L had an AUC of 0.61, glucose 7.28, and C-reactive protein >25 mg/L were associated with pleurodesis success in univariate analysis. None of these findings has been prospectively validated, and no study investigated the added value of fluid biochemistries to clinical variables. Conclusion: There is a scarcity in quantity and quality of data on fluid biomarkers to predict treatment response to definite pleural procedures for malignant pleural effusion.