Surgical management of solitary pulmonary nodules

Abstract

Background: In this study, we retrospectively reviewed the patients who were operated on for solitary pulmonary nodules (SPN). Methods: The medical records of 110 patients (96 males, 14 females; mean age 37.4 years; range 16 to 73 years) who were operated for SPNs between May 1995 and December 2008 were reviewed retrospectively. Results: Thirty five percent of the lesions were malignant and 65% were benign. Seventy six percent of the malignant nodules were diagnosed in patients over 40-years-old and 72% of the benign nodules were found in patients under 40-years of age. The lesions were metastatic in 82% (n=9). Ninety five percent of the solitary pulmonary nodules were resected via thoracotomy. Limited resection was performed in 85 (77%) of the patients and anatomic resection was performed in 25 (23%). Primary lung cancer was the diagnosis in 25% of all nodules and 74% of the malignant lesions. The majority of benign lesions were hamartomas (35%) and tuberculosis (33%). The five-year survival rate of the patients with primary lung cancer was calculated at 68%. While there was no mortality, morbidity involved eight (7%) patients. Conclusion: Since surgical resection can provide potential cure for lesions which represent early stage lung cancer, malignancy should be ruled out for all SPNs. There may be less predilection for operation if the likelihood of malignancy is low.