Thoracoscopic resection of a solitary pulmonary nodule in patients with a known history of malignancy

• Published in: The Thoracic and cardiovascular surgeon Vol. 56; no. 7; p. 418
• Main Authors: Laisaar, T, Vooder, T, Umbleja, T
• Format: Journal Article
• Language: English
• Published: Germany 01.10.2008
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms - mortality; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Male; Middle Aged; Neoplasms, Second Primary - mortality; Neoplasms, Second Primary - pathology; Neoplasms, Second Primary - surgery; Solitary Pulmonary Nodule - mortality; Solitary Pulmonary Nodule - secondary; Solitary Pulmonary Nodule - surgery; Thoracic Surgery, Video-Assisted; Time Factors; Treatment Outcome
• ISSN: 0171-6425
• DOI: 10.1055/s-2008-1038347

Solitary pulmonary nodules found during the follow-up of cancer patients are generally considered to be lung metastases. However, a definite diagnosis should be established. Between 1995 and 2005, all patients with a solitary lung nodule considered removable by a thoracoscopic approach and with a history of malignancy were included in this study. Lung wedge resection was performed to establish the morphological diagnosis. During follow-up further metastases and local recurrences were registered. Survival data were obtained in February 2007. Among our 34 patients (17 male and 17 female with a median age of 67.5 years), the most common primary cancers were colorectal (n = 12) and kidney (n = 6). Two patients had a history of 2 cancers. Twenty-two patients (65 %) had lung metastases and 12 (35 %) had benign nodules. During follow-up (median 2.4 years) 7 patients (21 %) developed further lung metastases. Overall postoperative five-year survival was 50 % (95 % CI: 35 - 73 %). Not all solitary lung nodules in patients with previous malignancy are metastases. According to our survival results the thoracoscopic removal of a single lung metastasis was curative in many patients.