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


METHODS
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.


RESULTS
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 %).


CONCLUSIONS
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.
Laisaar
T
T
Department of Thoracic Surgery, Tartu University Hospital, Tartu, Estonia. tanel.laisaar@kliinikum.ee
Vooder
T
T
Umbleja
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003074:Solitary Pulmonary Nodule / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D016896:Treatment Outcome