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Objectives: Asymptomatic lung lesions are more frequent with screening. We analyzed our surgical results in these patients with special emphasis on lung cancers.
Design: Retrospective patient series.
Setting: University Hospital.
Patients and Interventions: Patients with asymptomatic lung lesions who underwent surgery during 1996-2003 were included. Patients were grouped according to the histologic character and analyzed for age, smoking (pack-years), detection method, surgical procedure and survival. Statistical analysis was performed.
Results: Thirty-one (8.4%, 6 females) patients were asymptomatic. Twenty-two were malignant (Group 1) and 9 benign (Group 2). Group 1 was older (62±10 vs 46±15; p=0.002). Amount of smoking was higher in Group 1, but not significantly (38±29 vs 21 ±14; p=0.09). Lesions were detected on chest X-ray (n=26) and CT scan (n=5) during check-up (n=7); work-up for non-thoracic pathology (n=7), cardiovascular disease (n=4), and unrelated thoracic disease (n=4); preoperative work-up for non-thoracic disease (n=5); and during follow-up for non-thoracic malignant disease (n=4). Six of the benign lesions were tuberculosis. Nineteen patients had non-small cell lung cancer (NSCLC). Nine were stage I. NSCLC patients (n=19) had a two- and five-year survival of 63% and 42%, respectively. In the resected NSCLC patients (n=14), survival was 78% at two years and 51% at five years.
Conclusions: Asymptomatic malignant lung lesions tend to be at an earlier stage. Survival is high and may justify screening.