title: Clinical characteristics and survival of patients with surgically resected, incidentally detected lung cancer.
abstract: BACKGROUND
  There is little information on the clinical characteristics and outcomes of patients with surgically resected, incidentally detected lung cancers. Our hypothesis was that among patients with surgically resected non-small cell lung cancer (NSCLC), incidentally detected cancers were common, were less likely to require pneumonectomy, and were associated with better stage-adjusted survival.
  
  
  METHODS
  Two hundred seventy-four patients with NSCLC who underwent surgical resection between 1999 and 2004 were studied. The clinical characteristics of patients with incidentally detected and symptomatic NSCLC were compared. A proportional hazards model was used to compare the stage-adjusted mortality rate of patients with incidentally detected and symptomatic NSCLC.
  
  
  RESULTS
  One hundred patients (36%) had incidentally detected NSCLC. Patients with incidentally detected NSCLC had smaller and earlier-stage cancers, were less likely to undergo pneumonectomy (3% versus 13%, p = 0.005), and were more likely to have bronchioloalveolar carcinoma (15% versus 5%, p = 0.003). Patients with incidentally detected cancers had a stage-adjusted hazards ratio (HR) of mortality of 0.9 compared with symptomatic patients (0.6-1.4, p = 0.64). Patients with cancers detected incidentally on computed tomography (CT) had a stage-adjusted HR of 0.5 (0.2-1.5, p = 0.15).
  
  
  CONCLUSIONS
  Early-stage NSCLC is commonly detected incidentally. Patients with incidentally detected lung cancers are more likely to have bronchioloalveolar carcinoma histology, less likely to undergo pneumonectomy, and overall have similar stage-adjusted survival compared with symptomatic patients. Patients with cancers detected incidentally by CT scan may have better stage-adjusted survival, but our study was not sufficiently powered to detect this effect.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, CA 94131, USA. Dan.raz@ucsf.edu
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Raz
authors.forename: David V
authors.initials: DV
authors.lastname: Glidden
authors.forename: Anobel Y
authors.initials: AY
authors.lastname: Odisho
authors.forename: David M
authors.initials: DM
authors.lastname: Jablons
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis