title: Clinical management of solitary pulmonary micronodule: a pilot study.
abstract: BACKGROUND
  Solitary pulmonary micronodules (SPMN) characteristically have a diameter of 0.1-0.5cm.
  
  
  OBJECTIVE
  The aim of this prospective study is to evaluate the surgical approach to SPMN in order to establish the most appropriate treatment.
  
  
  METHODS
  Between January 2007 and June 2011, 146 SPMN patients (94 males and 52 females) were prospectively evaluated. Patients were divided into two groups based on history of malignancy (Group A, 59 patients) and generic risk factors for lung cancer (Group B, 87 patients). After gathering patient information, we proposed surgery or thin-section computed tomography (TSCT) follow-up to both Groups.
  
  
  RESULTS
  Preference for surgery versus TSCT follow-up was 90% versus 10% in Group A and 78% versus 22% in Group B, respectively. In Group A, we discovered 46 metastases from previous cancer (78%), 8 primary lung cancers (14%) and 5 benign lesions (8%). In Group B, we found 5 metastases (6%), 13 non-small-cell lung cancer (15%) and 69 benign lesions (79%). Statistical analysis revealed a high positive predictive value (PPV = 0.9) between total surgical patients versus TSCT follow-up patients.
  
  
  CONCLUSIONS
  The indication for surgery in solitary pulmonary micronodules is aimed at establishing early diagnosis and curing malignant disease. Our study indicates that in patients with previous cancer, surgery is essential. In patients with generic risk for lung cancer, surgical indications should be contemplated more carefully, even though the pulmonary malignancy rate of 21% in Group B seems to indicate the advisability of surgery.
authors.affiliation: Department of Thoracic Surgery, University of L'Aquila, G. Mazzini Hospital, Teramo, Italia.
authors.forename: Roberto
authors.initials: R
authors.lastname: Crisci
authors.forename: Duilio
authors.initials: D
authors.lastname: Divisi
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000601:surgery*