Eric Sumner

All Publications

• Cone Beam Computed Tomography-Guided Bronchoscopy versus Computed Tomography-Guided Transthoracic Needle Biopsy for Peripheral Pulmonary Lesion Diagnosis. Chest Patel, P., Ost, D. E., Shaller, B., Chang, J., Yenepalli, A., Choi, H. J., Free, D., Kang, C. Y., Sumner, E., Cao, C., Bedi, H. 2026

  Abstract

  The identification of peripheral pulmonary lesions (PPLs) has increased significantly, either incidentally or through lung cancer screening, necessitating more biopsies to differentiate between malignant and benign etiologies. Cone beam computed tomography-guided bronchoscopic biopsy (CBCT-GB) and computed tomography-guided transthoracic needle biopsy (CT-TTNB) are commonly used for these biopsies, but their comparative diagnostic abilities have not been studied.How does CBCT-GB compare to CT-TTNB for diagnosing PPLs?This single-center retrospective comparative cohort study analyzed PPLs biopsied at an academic center via either CBCT-GB or CT-TTNB. The primary outcome was diagnostic accuracy at 24-month follow-up, defined as the proportion of cases yielding a specific diagnosis (malignant or non-malignant) or a non-specific diagnosis that remained accurate through 24 months of clinical follow-up. Secondary outcomes included complication rates, procedure duration, radiation exposure, and the need for additional diagnostic procedures.Out of 895 patients analyzed, 340 of 375 (90.7%) in the CBCT-GB group and 440 of 475 (92.6%) in the CT-TTNB group had a diagnostic result (p=0.301, Odds Ratio 0.979, 95% CI: 0.939-1.020). Complications occurred in 4.3% of CBCT-GB patients and 41.6% of CT-TTNB patients (p<0.001). Pneumothorax rates were 1.8% for CBCT-GB and 31.4% for CT-TTNB (p<0.001), while severe bleeding or cardiorespiratory failure occurred in 3.3% and 6.0% of patients respectively (p<0.001). Among patients meeting criteria for upfront invasive mediastinal staging, 86.5% of CBCT-GB patients received it at the time of PPL biopsy, compared to 14.0% after biopsy in the CT-TTNB group (p<0.001). Median effective radiation dose was 8.6 millisieverts in the robotic bronchoscopy CBCT-GB group and 7.5 millisieverts in the CT-TTNB group (p=0.074).CBCT-GB demonstrated a 24-month diagnostic accuracy comparable to CT-TTNB while offering improved safety and concurrent mediastinal lymph node staging. This data supports CBCT-GB as the optimal initial procedure for PPL diagnosis.

  View details for DOI 10.1016/j.chest.2026.02.038

  View details for PubMedID 41895580

• State of the art: peripheral diagnostic bronchoscopy. Journal of thoracic disease Sumner, E. T., Chang, J., Patel, P. R., Bedi, H., Shaller, B. D. 2024; 16 (8): 5409-5421

  Abstract

  Lung cancer is the leading cause of cancer related death worldwide and in the United States according to the World Health Organization and National Cancer Institute. Improvements in the diagnosis and treatment of lung cancer are of the utmost importance. A prompt diagnosis is a crucial factor to improve outcomes in the treatment of lung cancer. Although the implementation of lung cancer screening guidelines and the overall steady growth in the use of computed tomography have improved the likelihood of detecting lung cancer at an earlier stage, the diagnosis of peripheral pulmonary lesions (PPLs) has remained a challenge. The bronchoscopic techniques for PPL sampling have historically offered modest diagnostic yields at best in comparison to computed tomography guided transthoracic needle aspiration (TTNA). Fortunately, recent advances in technology have ushered in a new era of diagnostic peripheral bronchoscopy. In this review, we discuss the introduction of advanced intraprocedural imaging included digital tomosynthesis (DT), augmented fluoroscopy (AF), and cone beam computed tomography. We discuss robotic assisted bronchoscopy with a review of the currently available platforms, and we discuss the implementation of novel biopsy tools. These technologic advances in the bronchoscopic approach to PPLs offer greater diagnostic certainty and pave the way toward peripheral therapeutics in bronchoscopy.

  View details for DOI 10.21037/jtd-24-346

  View details for PubMedID 39268128

  View details for PubMedCentralID PMC11388231

• Society of Asian Academic Surgeons Utilization and Outcomes of Observation for Spontaneous Pneumothorax at an Integrated Health System JOURNAL OF SURGICAL RESEARCH Kwak, H. V., Banks, K. C., Hung, Y., Brennan, P. G., Wilde, S. A., Sumner, E. T., Sun, A., Hsu, D. S., Velotta, J. B. 2023; 288: 28-37

  Abstract

  Though limited, recent evidence supports observation rather than intervention for spontaneous pneumothorax management. We sought to compare the utilization and outcomes between observation and intervention for patients with primary and secondary spontaneous pneumothoraces.A retrospective cohort study of all adults presenting to Kaiser Permanente Northern California emergency rooms with spontaneous pneumothorax from 2016 to 2020 was performed. Those with prior pneumothoraces, tension physiology, bilateral pneumothoraces, effusions, and prior thoracic procedures or surgery on the affected side were excluded. Groups included observation versus intervention. Baseline clinicodemographic variables and outcomes were compared. Treatment was considered successful if further interventions were not required for pneumothorax resolution. Wilcoxon rank-sum tests, chi-square tests, Fischer exact tests, and multivariable logistic regression models were performed.Of the 386 patients with primary spontaneous pneumothorax, age, race/ethnicity, body mass index, smoking status, and the Charlson comorbidity index were not different between treatment groups. Of 86 patients with secondary spontaneous pneumothorax, age, gender, and smoking status were not different between treatment groups. Among patients with primary pneumothoraces, 83 underwent observation while 303 underwent intervention. The success rate was 92.8% for observation and 60.4% for intervention (P < 0.0001). Among patients with secondary pneumothoraces, 15 underwent observation while 71 underwent intervention, with a successful rate of 73.3% for observation and 32.4% for intervention (P = 0.003).Given the high success rates for observation of both small and moderate primary and secondary pneumothoraces, observation should be considered for clinically stable patients. Observation may be the superior choice for decreasing morbidity and healthcare costs.

  View details for DOI 10.1016/j.jss.2023.02.031

  View details for Web of Science ID 000957690100001

  View details for PubMedID 36948030

• Trends in Smoking-Specific Lung Cancer Incidence Rates Within a US Integrated Health System, 2007-2018. Chest Sakoda, L. C., Alabaster, A., Sumner, E. T., Gordon, N. P., Quesenberry, C. P., Velotta, J. B. 2023

  Abstract

  BACKGROUND: At least 10%of lung cancers arise in adults who have never used tobacco. Data remain inconclusive on whether lung cancer incidence has been increasing among adults who have never used tobacco.RESEARCH QUESTION: How have age-adjusted incidence rates of lung cancer changed temporally, especially among adults who have never used tobacco?STUDY DESIGN AND METHODS: Trends in lung cancer incidence were examined using linked electronic health record and cancer registry data on a dynamic cohort of adults≥ 30 years of age at risk of incident lung cancer between January 1, 2007, and December 31, 2018, from an integrated health-care system in northern California. Truncated age-adjusted lung cancer incidence rates and average annual percentage change (AAPC) in rates were estimated, overall and separately for adults who have ever and never used tobacco by age, sex, and race or ethnicity.RESULTS: The cohort included 3,751,348 adults (52.5%female, 48.0%non-Hispanic White, 63.1%have never used tobacco), among whom 18,627 (52.7%female, 68.6%non-Hispanic White, 15.4%have never used tobacco) received a diagnosis of lung cancer. The overall lung cancer incidence rate declined from 91.1 to 63.7 per 100,000 person-years between 2007 and 2009 and between 2016 and 2018 (AAPC, -3.9%; 95%CI, -4.2%to -3.6%). Among adults who have ever used tobacco, incidence rates declined overall from 167.0 to 113.4 per 100,000 person-years (AAPC, -4.2%; 95%CI, -4.4%to -3.9%) and, to varying degrees, within all age, sex, and racial or ethnic groups. Among adults who have never used tobacco, incidence rates were relatively constant, with 3-year-period estimates ranging from 19.9 to 22.6 per 100,000 person-years (AAPC, 0.9%; 95%CI, -0.3%to 2.1%). Incidence rates for adults who have never used tobacco seemed stable over time, within age, sex, and racial or ethnic groups, except for those of Asian and Pacific Islander (API) origin (AAPC, 2.0%; 95%CI, 0.1%-3.9%), whose rates were about twice as high compared with their counterparts.INTERPRETATION: These observed trends underscore the need to elucidate further the cause of lung cancer in adults who have never used tobacco, including why incidence is higher and rising in API adults who have never used tobacco.

  View details for DOI 10.1016/j.chest.2023.03.016

  View details for PubMedID 36934804

• TRACHEAL AND BRONCHIAL STENOSIS CAUSED BY CHRONIC UNCONTROLLED GASTROESOPHAGEAL REFLUX DISEASE Marquez, A., Sumner, E. T., Le, P. T. ELSEVIER. 2022: 2477A

  View details for DOI 10.1016/j.chest.2022.08.2030

  View details for Web of Science ID 000895468902348

• Sociodemographic and clinical characteristics associated with never-smoking status in patients with lung cancer: findings from a large integrated health system TRANSLATIONAL CANCER RESEARCH Banks, K. C., Sumner, E. T., Alabaster, A., Hsu, D. S., Quesenberry Jr, C. P., Sakoda, L. C., Velotta, J. B. 2022; 11 (10): 3522-3534

  Abstract

  Evidence is limited characterizing sociodemographically diverse patient populations with lung cancer in relation to smoking status.In a cross-sectional analysis of adults diagnosed with lung cancer at ages ≥30 years from 2007-2018 within an integrated healthcare system, overall and sex-specific prevalence of never smoking were estimated according to sociodemographic and clinical characteristics. Adjusted prevalence ratio (aPR) and 95% confidence interval (CI) were also estimated using modified Poisson regression to identify patient characteristics associated with never smoking, overall and by sex. Similar analyses were conducted to explore whether prevalence and association patterns differed between non-Hispanic White and Asian/Pacific Islander patients.Among 17,939 patients with lung cancer, 2,780 (15.5%) never smoked and 8,698 (48.5%) had adenocarcinoma. Overall prevalence of never smoking was higher among females than males (21.2% vs. 9.2%, aPR 2.13, 95% CI: 1.98-2.29); Asian/Pacific Islander (aPR 2.85, 95% CI: 2.65-3.07) and Hispanic (aPR 1.72, 95% CI: 1.51-1.95) than non-Hispanic White patients; patients who primarily spoke Spanish (aPR 1.60, 95% CI: 1.32-1.94), any Asian language (aPR 1.20, 95% CI: 1.10-1.30), or other languages (aPR 1.84, 95% CI: 1.27-2.65) than English; patients living in the least vs. most deprived neighborhoods (aPR 1.36, 95% CI: 1.24-1.50); and patients with adenocarcinoma (aPR 2.57, 95% CI: 2.18-3.03), other non-small cell lung cancer (NSCLC) (aPR 2.00, 95% CI: 1.63-2.45), or carcinoid (aPR 3.60, 95% CI: 2.96-4.37) than squamous cell carcinoma tumors. Patterns of never smoking associated with sociodemographic, but not clinical factors, differed by sex. The higher prevalence of never smoking associated with Asian/Pacific Islander race/ethnicity was more evident among females (aPR 3.30, 95% CI: 2.95-3.47) than males (aPR 2.25, 95% CI: 1.92-2.63), whereas the higher prevalence of never smoking associated with living in the least deprived neighborhoods was more evident among males (aPR 1.93, 95% CI: 1.56-2.38) than females (aPR 1.18, 95% CI: 1.06-1.31). Associations between primary language and never-smoking status were found only among females. Overall and sex-specific prevalence and association patterns differed between Asian/Pacific Islander and non-Hispanic white patients.Our findings suggest that patterns of never-smoking status associated with sociodemographic and clinical characteristics are different across sex and race/ethnicity among patients with lung cancer. Such data are critical to increasing awareness and expediting diagnosis of this disease.

  View details for DOI 10.21037/tcr-22-1438

  View details for Web of Science ID 000850809600001

  View details for PubMedID 36388017

  View details for PubMedCentralID PMC9641079

• Endobronchial Leiomyoma Successfully Resected with Electrocautery Snare Sumner, E. T., Le, P. T., Quick, B. D. AMER THORACIC SOC. 2022

  View details for Web of Science ID 000792480404354

• YELLOW NAIL SYNDROME PLEURAL ENTRAPMENT SUCCESSFULLY TREATED WITH INTRAPLEURAL CATHETER PLACEMENT FOLLOWED BY PLEURODESIS Sumner, E., Le, P. ELSEVIER. 2021: 1310A

  View details for DOI 10.1016/j.chest.2021.07.1200

  View details for Web of Science ID 000709108701357

• The Association of Race/Ethnicity and Body Mass Index Within a Multi-Ethnic Cohort of Patients Diagnosed with Obstructive Sleep Apnea Sumner, E. T., Darbinian, J., Ramalingam, N., Durr, M., Tzeng, D., Lo, J. AMER THORACIC SOC. 2019

  View details for Web of Science ID 000466771103162