Thoracoscopic Resection of a Solitary Pulmonary Nodule in Patients with a Known History of Malignancy

Abstract

Background: Solitary pulmonary nodules found during the follow-up of cancer patients are generally considered to be lung metastases. However, a definite diagnosis should be established. Methods: Between 1995 and 2005, all patients with a solitary lung nodule considered removable by a thoracoscopic approach and with a history of malignancy were included in this study. Lung wedge resection was performed to establish the morphological diagnosis. During follow-up further metastases and local recurrences were registered. Survival data were obtained in February 2007. Results: Among our 34 patients (17 male and 17 female with a median age of 67.5 years), the most common primary cancers were colorectal (n = 12) and kidney (n = 6). Two patients had a history of 2 cancers. Twenty-two patients (65 %) had lung metastases and 12 (35 %) had benign nodules. During follow-up (median 2.4 years) 7 patients (21 %) developed further lung metastases. Overall postoperative five-year survival was 50 % (95 % CI: 35 – 73 %). Conclusion: Not all solitary lung nodules in patients with previous malignancy are metastases. According to our survival results the thoracoscopic removal of a single lung metastasis was curative in many patients.

lung metastasis - solitary pulmonary nodule - VATS

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