title: The solitary pulmonary nodule in patients with previous cancer history: results of surgical treatment.
abstract: BACKGROUND
  The present study was carried out to evaluate the characteristics of solitary pulmonary nodule (SPN) in patients with previous cancer(s) and to analyse the outcome of its surgical treatment.
  
  
  METHODS
  We retrospectively analysed 131 patients with history of previous malignancy submitted to lung surgery for new identified SPN between January 2004 and December 2009.
  
  
  RESULTS
  The diagnosis was metastasis in 65 patients, primary lung cancer in 57, benign lesion in 9. Primary lung cancers were significantly larger, had higher maxSUV at CT-PET scanning, occurred after a longer disease-free interval in patients older and with worse lung function when compared with metastatic lesions. Overall survival at 5-year was 67% for benign lesions, 62% for primary lung cancer, 48% for metastatic disease. Histological subtype, SPN diameter less than 2 cm and DFI >36 months were factors influencing long-term prognosis of metastatic patients. Histological subtype and pathological staging were factors influencing long-term outcome of primary lung cancer patients.
  
  
  CONCLUSIONS
  Surgical resection of solitary pulmonary nodule is essential in patients with history of previous cancer to rule out benign lesions, to offer diagnostic confirmation and local control of the disease in metastatic tumours and to correctly stage and treat primary lung cancer.
authors.affiliation: Thoracic Surgery Unit, University of Eastern Piedmont, Via Frasconi, 14, I-28100 Novara, Italy. Electronic address: ottaviorena@libero.it.
authors.forename: O
authors.initials: O
authors.lastname: Rena
authors.forename: F
authors.initials: F
authors.lastname: Davoli
authors.forename: R
authors.initials: R
authors.lastname: Boldorini
authors.forename: A
authors.initials: A
authors.lastname: Roncon
authors.forename: G
authors.initials: G
authors.lastname: Baietto
authors.forename: E
authors.initials: E
authors.lastname: Papalia
authors.forename: D
authors.initials: D
authors.lastname: Turello
authors.forename: F
authors.initials: F
authors.lastname: Massera
authors.forename: C
authors.initials: C
authors.lastname: Casadio
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000175:diagnosis; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome
keywords: Benign pulmonary lesion; Metastasis; Primary lung cancer; Solitary pulmonary nodule; Surgery; Survival