Surgery and invasive diagnostic procedures for benign disease are rare in a large low-dose computed tomography lung cancer screening program

Ho, Helen; Williamson, Christina; Regis, Shawn M.; Stock, Cameron; Quadri, Syed M.; McKee, Brady; McKee, Andrea B.; Servais, Elliot L.

doi:10.1016/j.jtcvs.2020.08.109

Cited by 14 publications

(7 citation statements)

References 38 publications

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“…In previous lung cancer screening trials, 49-81% of patients who will undergo surgical resection of these nodules do not have a preoperative diagnosis (43,44). Furthermore, while 73-91% presented with clinical stage I disease, only 18-48% were treated by sublobar resections (43,44). Comparably, the percentage of sublobar resections in our study is fairly low as well.…”

Section: Discussionsupporting

confidence: 41%

“…With the advent of lung cancer screening with low-dose CT (40)(41)(42), a large number of patients with small pulmonary nodules will be detected and presented to multidisciplinary team meetings. In previous lung cancer screening trials, 49-81% of patients who will undergo surgical resection of these nodules do not have a preoperative diagnosis (43,44). Furthermore, while 73-91% presented with clinical stage I disease, only 18-48% were treated by sublobar resections (43,44).…”

Section: Discussionmentioning

confidence: 99%

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Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice?

Ghamati¹,

Li²,

Heijden³

et al. 2021

J Thorac Dis

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Background: There are discordances in the guidelines regarding the need to acquire histological diagnosis before surgical treatment of (presumed) lung cancer. Preoperative histological confirmation is always encouraged in this setting to prevent unnecessary surgery or when sublobar resection for small-sized tumors is considered. The aim of this retrospective cohort study was to assess the proportion of patients undergoing lung cancer resection in the Netherlands without preoperative pathological confirmation, based on the intraoperative pathological diagnosis (IOD) rate, and to determine characteristics that may influence IOD frequency. Methods: Data on 10,226 patients, who underwent surgical treatment for lung cancer from 2010 to 2015, were retrieved from the Netherlands National Cancer Registry. We registered an IOD when the date of diagnosis equaled the date of the first surgical intervention. Tabulations and multivariable logistic regression were used to identify predictive parameters for IOD. Results: 36% of surgical procedures were classified as IOD, and decreased with increasing tumor size and extent of surgery (57% for segmentectomy, 39% for lobectomy and 11% for pneumonectomy). IOD was more frequently observed in adenocarcinoma (41%), varied between hospitals from 13% to 66% and was less common when patients were referred from a hospital where thoracic surgery was not performed. Previous history of cancer did not affect IOD. Conclusions: More than one-third of patients with suspected lung cancer in the Netherlands was operated without preoperative histological confirmation. There was significant variation in IOD rates between different hospitals, which deserves further detailed analysis when striving for uniform surgical quality of care for patients with lung cancer.

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Section: Discussionsupporting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice?

Ghamati¹,

Li²,

Heijden³

et al. 2021

J Thorac Dis

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“… 17 In a single-center, retrospective study among patients selected from LCS, Ho et al. 18 found that benign nodules accounted for 14 of 83 (16.9%) resections for Lung-RADS 4 nodules and 0.43% (14 of 3280) of total patients screened for lung cancer and comparable to our results. In a study by Rzyman et al.…”

Section: Discussionsupporting

confidence: 89%

Surgical Resection of Benign Nodules in Lung Cancer Screening: Incidence and Features

Archer,

Mendoza,

Hung

et al. 2023

JTO Clinical and Research Reports

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“…That represents a 3% yield, and only 15 patients (0.45%) underwent some type of surgical procedure in which the result did not confirm cancer, with practically no morbidity and zero mortality. 125 …”

Section: Risks Associated With Lcsmentioning

confidence: 99%

Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging

Ferreira Pereira1,

Sales dos Santos2,3,

Oliveira Bonomi4

et al. 2024

J Bras Pneumol.

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Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.

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Surgery and invasive diagnostic procedures for benign disease are rare in a large low-dose computed tomography lung cancer screening program

Cited by 14 publications

References 38 publications

Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice?

Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice?

Surgical Resection of Benign Nodules in Lung Cancer Screening: Incidence and Features

Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging

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