Author of

• 20180

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  P2.16 - Surgery (ID 717)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23547

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    P2.16-016 - Surgical Treatment of Indeterminate Lung Nodules (ID 9795)

    09:30 - 09:30  |  Author(s): Y. Matsuura
    • Abstract

    Background:
    Recently, the improvement of ability of Computed tomography (CT) scans permits us to identify a large number of small peripheral, undefined pulmonary lesions that require a diagnosis. Although the large majority of these cases are benign, diagnostic approaches to discriminate benign nodules from malignant nodules remain most-unsatisfactory.　 So we often have to perform thoracoscopic resection with the primary objective of diagnosis. In this study, we examined the clinicopathological findings in the cases of indeterminate pulmonary nodules in which thoracoscopic or open excisional biopsy was performed.
    
    Method:
    From a single institutional database, a total of 253 patients diagnosed with lung cancer or suspected lung cancer underwent resection between January 2014 and March 2017. In 155 patients, a histological diagnosis was not obtained preoperatively. This study was intended for 108 patients diagnosed with lung cancer after surgery among the 155 indeterminate pulmonary nodules.
    
    Result:
    Out of 155, 108 patients were diagnosed as primary lung cancer by intraoperative frozen section or postoperative pathological examination. Twenty-six patients were diagnosed as metastatic lung tumors, and 21 patients were diagnosed as other, such as benign inflammatory changes. Surgical resection of indeterminate　lung　nodules (mean diameter 20.6mm, range 3 to 53 mm) were performed in 108 primary lung cancer cases, which represented 52.4% of the 206 resections for lung cancer performed during the study period. There were 57 men and 51 women with an average age of 70.6 years old (47-91 years old). A biopsy needle (13cases) or wedge resection (61cases) was used to the methods of intraoperative diagnosis. The remaining 34 cases performed a final pathological examination after surgery without intraoperative diagnosis. Nineteen small pulmonary nodules that include ground-glass attenuation required preoperative computed tomography-guided lipiodol marking to identify the position of a nodule. The postoperative stage was 0 in 17 patients （16％）, IA in 66 （61％）, IB in 11 （10％）, IIA in 1 （1％）, IIA in 3 （3％）, IIIA in 8 （7％）, and IV in 2 （2％）.
    
    Conclusion:
    The small pulmonary nodules that include ground-glass attenuation are tricky to diagnose. When CT findings are highly suggestive of lung cancer, we think that positive lung biopsy under thoracoscopic surgery is necessary to detect lung cancer.