Extrathoracic staging of non-small cell bronchogenic carcinoma: relationship of the clinical evaluation to organ scans.
OBJECTIVE
The aim of this study was to investigate the value of systemic evaluation of extrathoracic extension of non-small cell lung cancer and to assess the value of the clinical evaluation in detecting extrathoracic metastases.


METHODS
The study included 90 patients [87 men, three women; mean age 57.5 years (range 28-76)] with potentially resectable non-small cell carcinoma. Fifty-two were squamous cell carcinomas and 38 were adenocarcinomas. Organ-specific and non-organ-specific clinical findings suggesting metastases were analysed and computed tomographic scans of the brain and abdomen and whole-body bone scanning were performed in all patients.


RESULTS
Extrathoracic metastases were detected in 23 (25.5%) of 90 patients. The metastases were located in the following areas: brain (n = 12, 13.3%); bone (n = 9, 10%); liver (n = 5, 5.6%); and adrenal gland (n = 5, 5.5%). Histological analysis revealed metastases in 21.1% (11/52) of the squamous cell carcinomas and 31.6% (12/38) of the adenocarcinomas (P > 0.05). Eleven (47.8%) of the 23 patients with extrathoracic metastases had no organ-specific clinical findings suggesting metastases. Eight patients with squamous cell carcinomas were intrathoracic T1N0 stage and in two (25%) of these patients extrathoracic metastases were detected. These patients had no organ-specific or non-organ-specific clinical factors suggesting metastases.


CONCLUSIONS
Evaluation of extrathoracic extension should be routinely performed in all patients with newly diagnosed lung cancer. This approach will prevent many unnecessary thoracotomies.
Bilgin
Sevinç
S
SSK Süreyyapasa Center for Chest Disease and Thoracic Surgery, Istanbul, Turkey.
Yilmaz
Adnan
A
Ozdemir
Filiz
F
Akkaya
Esen
E
Karakurt
Zuhal
Z
Poluman
Arman
A
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000556:secondary; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000556:secondary*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed