title: Determination of a low risk group for having metastatic nodules not detected by computed tomography scan in lung metastases surgery.
abstract: BACKGROUND
  In recent years, there has been debate regarding the diagnostic accuracy of computed tomography (CT) in the identification of lung metastases and the need for lung palpation to determine the number of metastatic nodules. The aim of this study was to determine in which patients the CT scan was more effective in detecting all metastases.
  
  
  METHODS
  We studied all patients who underwent curative thoracotomy for pulmonary metastasis between 1998 and 2012. All cases were reviewed by two expert pulmonary radiologists before surgery. Statistical analyses were performed using Systat version 13.
  
  
  RESULTS
  The study included 183 patients (63.6% male) with a mean age of 61.7 years who underwent 217 interventions. The CT scan was correct in 185 cases (85.3%). Discrepancies observed: 26 patients (11.9%) with more metastases resected than observed and 6 cases (2.8%) with fewer metastases. In patients with one or two metastases of colorectal origin or a single metastasis of any other origin, the probability of finding extra nodules was 9.5%. In the remaining patients, the probability was 27.8%, with statistically significant differences (P=.001). The mean age of the patients in whom no unobserved nodules were detected was 62.9 years compared to 56.5 years on average in patients who were free from any metastases (P=.001).
  
  
  CONCLUSIONS
  Patients older than 60 years, with one or two metastases of colorectal origin or a single metastasis from any other origin were considered to be the group with low probability of having more metastases resected than observed.
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Donostia, Donostia, Gipuzkoa, España. Electronic address: jon.zabaletajimenez@osakidetza.net.
authors.forename: Jon
authors.initials: J
authors.lastname: Zabaleta
authors.forename: Borja
authors.initials: B
authors.lastname: Aguinagalde
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Izquierdo
authors.forename: Mikel
authors.initials: M
authors.lastname: Mendoza
authors.forename: Francisco
authors.initials: F
authors.lastname: Basterrechea
authors.forename: Maialen
authors.initials: M
authors.lastname: Martin-Arruti
authors.forename: Carmen
authors.initials: C
authors.lastname: Lobo
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Emparanza
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D012189:Retrospective Studies; D012306:Risk; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted; D036542:Tomography, Spiral Computed; D014565:Urogenital Neoplasms / Q000473:pathology; D055815:Young Adult
keywords: Cirugía torácica; Computed tomography scan; Lung metastasectomy; Lung metastases; Metastasectomía pulmonar; Metástasis pulmonar; Thoracic surgery; Thoracotomy; Tomografía axial computarizada; Toracotomía