title: Resection of solitary pulmonary lesion is beneficial to patients with a history of malignancy.
abstract: BACKGROUND
  Solitary pulmonary lesion poses a diagnostic challenge, especially in patients with a history of malignancy. The purpose of this study was to evaluate the characteristics of solitary pulmonary lesions and the outcome of surgical resection.
  
  
  METHODS
  We retrospectively analyzed 243 patients with a history of cancer who underwent surgery for new-found solitary pulmonary lesion between January 1998 and December 2007.
  
  
  RESULTS
  The diagnosis was primary lung cancer in 92 patients, metastasis in 133, and benign lesions in 18. The 5-year survival rate was 67.9% in all patients, 74.6% in those with primary lung cancer, 62.8% in those with metastasis, and 79.9% in those with benign lesions (p = 0.56). In metastasis patients, history of extrapulmonary recurrence and larger diameter lesion were risk factors for recurrence by multivariate analysis. History of cancers other than colorectal and bone and soft tissue sarcoma and shorter disease-free interval were indicators of poor prognosis. Pathologic stage was the only indicator of prognosis for primary lung cancer, and none of the factors concerning antecedent cancer influenced prognosis.
  
  
  CONCLUSIONS
  Surgical resection of solitary pulmonary lesion is essential in patients with a history of cancer because substantial numbers of benign lesions are included. In the case of malignancy, metastasectomy had a life-prolonging effect for selected patients, and prognosis of primary lung cancer was no worse than for the general population if treated appropriately. It is important not to hesitate to take a surgical approach for a diagnosis and to treat with standard therapy for primary lung cancer.
authors.affiliation: Department of Cardiothoracic Surgery, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Murakawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kitano
authors.forename: Tomonori
authors.initials: T
authors.lastname: Murayama
authors.forename: Takehiro
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D002648:Child; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D055815:Young Adult