Lung Cancer |

Lung Cancer as an Incidental or Screening Finding: Is Clinical Behavior Different? FREE TO VIEW

Ileana Palma*, MD; Silvia Quadrelli, MD; Gustavo Lyons, MD; Lorena Maldonado, MD; Lorena Delisio, MD; Leonardo Pankl, MD; Domingo Chimondeguy, MD
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British Hospital of Buenos Aires, Buenos Aires, Argentina

Chest. 2012;142(4_MeetingAbstracts):633A. doi:10.1378/chest.1389399
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SESSION TYPE: Lung Cancer Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To analyze the clinical features and survival in patients with diagnosed non small cell lung cancer (NSCLC) undergoing a surgical procedure with curative intent and that were detected incidentally or by screening.

METHODS: Retrospectively collected data was analysed, at a single center, on 593 patients undergoing lung resection for NSCLC with curative intent between January 1986 and November 2011. They were divided into 2 groups: patients with incidental diagnosis (asymptomatic: ASX) and symptomatic (SX).

RESULTS: 320 patients were ASX (53.9%), and older than SX (median age 61.9 ± 9.9 vs. 59.51 years/old ± 10.2, p= 0.007), without differences in sex (men 66 vs. 73.5%, p= 0.084). They had a higher prevalence of previous malignancy (13.2 vs. 4.8%, p= 0,002), and smokers, but smaller proportion (including ex-smokers 83.2 vs. 91.7%, p= 0.006) compared with SX. The frequency of presentation as SPN (49.5 vs. 19.4%, p <0.001) or peripheral location (80.3 vs 63.7%, p <0.001) were higher in this group, without differences in clinical suspicion of N2 (8.8 vs. 12.9%, p= 0.146). The resection was considered curative in most cases (90.5 vs. 82.3%, p= 0.007) and the rate of postoperative complications (18.9% vs. 27.9% p= 0,022) was lower in ASX, however, they had similar length of stay in intensive care unit (1.73 ± 4.38 vs. 1.44 days ± 3.2, p= 0.378). They presented less proportion of squamous carcinoma (16 vs. 23.9 p=0,031) and tumors were smaller than 3 cm. (50.5 vs. 23.3%, p <0,001). In pathological staging, they had marked predominance of stage IA in ASX patients (34 vs. 16.1%, p<0.001). This was different in SX, who presented higher frequency of advanced disease, particularly IIIA stage (13.7 vs. 25.6%) The median overall survival was greater in ASX (77.6 ± 9.7 vs. 42.9 ± 7.9 months, Kaplan-Meier log Rank p = 0.001), persisting in IA stage (162.9 vs. 65.6 months, Kaplan-Meier log Rank p = 0.020). When we analized the last ten years, we observed a high prevalence of incidental detection compared to previous years (51.7 vs. 39.8%, p= 0.008).

CONCLUSIONS: In the diagnosis of NSCLC as an incidental finding, we observed that it was more common in smokers, with a history of previous malignancy, with a greater proportion of SPN in I stage. The mortality in patients with incidental diagnosis is lower and this difference persists into IA stage.

CLINICAL IMPLICATIONS: There is little information on the clinical characteristics and evolution of these patients.

DISCLOSURE: The following authors have nothing to disclose: Ileana Palma, Silvia Quadrelli, Gustavo Lyons, Lorena Maldonado, Lorena Delisio, Leonardo Pankl, Domingo Chimondeguy

No Product/Research Disclosure Information

British Hospital of Buenos Aires, Buenos Aires, Argentina




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