دورية أكاديمية
أعرض في EDS

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

التفاصيل البيبلوغرافية
العنوان: Surgery and invasive diagnostic procedures for benign disease are rare in a large low-dose computed tomography lung cancer screening program.
المؤلفون: Ho H; Division of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, Mass., Williamson C; Division of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, Mass; Tufts University School of Medicine, Boston, Mass., Regis SM; Tufts University School of Medicine, Boston, Mass; Division of Radiation Oncology, Lahey Hospital and Medical Center, Burlington, Mass., Stock CT; Division of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, Mass; Tufts University School of Medicine, Boston, Mass., Quadri SM; Division of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, Mass; Tufts University School of Medicine, Boston, Mass., McKee BJ; Tufts University School of Medicine, Boston, Mass; Division of Radiology, Lahey Hospital and Medical Center, Burlington, Mass., McKee AB; Tufts University School of Medicine, Boston, Mass; Division of Radiation Oncology, Lahey Hospital and Medical Center, Burlington, Mass., Servais EL; Division of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, Mass; Tufts University School of Medicine, Boston, Mass. Electronic address: Elliot.Servais@lahey.org.
المصدر: The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2021 Mar; Vol. 161 (3), pp. 790-802.e2. Date of Electronic Publication: 2020 Sep 08.
نوع المنشور: Journal Article; Webcast
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: St. Louis, MO : Mosby
Original Publication: St. Louis.
مواضيع طبية MeSH: Early Detection of Cancer* , Radiation Dosage* , Tomography, X-Ray Computed* , Unnecessary Procedures*, Lung Neoplasms/*diagnostic imaging, Aged ; Diagnostic Errors ; Female ; Humans ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Program Evaluation ; Reproducibility of Results ; Retrospective Studies
مستخلص: Objective: Lung cancer screening with low-dose chest computed tomography improves survival. However, concerns about overdiagnosis and unnecessary interventions persist. We reviewed our lung cancer screening program to determine the rate of surgery and invasive procedures for nonmalignant disease.
Methods: We reviewed all patients undergoing lung cancer screening from January 2012 to June 2017 with follow-up through January 2019. Patients with suspicious findings (Lung CT Screening Reporting and Data System 4) were referred for further evaluation.
Results: Of 3280 patients screened, 345 (10.5%) had Lung CT Screening Reporting and Data System 4 findings. A total of 311 patients had complete follow-up, of whom 93 (29.9%) were diagnosed with lung cancer. Eighty-three patients underwent lung surgery (2.5% of screened patients). Forty patients underwent lobectomy (48.2%), 3 patients (3.6%) underwent bilobectomy, and 40 patients (48.2%) underwent sublobar resection. Fourteen patients underwent surgery for benign disease (0.43% of screened patients). Fifty-four patients, 5 with benign disease, had at least 1 invasive diagnostic procedure but never underwent surgery. The incidence of any invasive intervention for nonmalignant disease was 0.95% (31/3280 patients). There were no postprocedural deaths within 60 days. Twenty-five patients (0.76%) underwent stereotactic body radiation therapy; 19 patients (76%) had presumed lung cancer without pretreatment pathologic confirmation.
Conclusions: Surgical resection for benign disease occurred in 0.43% of patients undergoing lung cancer screening. The combined incidence of any invasive diagnostic or therapeutic intervention, including surgical resection, for benign disease was only 0.95%. Periprocedural complications were rare. These results indicate that concern over unnecessary interventions is overstated and should not hinder adoption of lung cancer screening. A multidisciplinary team approach, including thoracic surgeons, is critical to maintain an appropriate rate of interventions in lung cancer screening.
(Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: J Thorac Cardiovasc Surg. 2021 Mar;161(3):804-805. (PMID: 32950236)
Comment in: J Thorac Cardiovasc Surg. 2021 Mar;161(3):805-806. (PMID: 32988611)
Comment in: J Thorac Cardiovasc Surg. 2021 Mar;161(3):803-804. (PMID: 33036748)
فهرسة مساهمة: Keywords: low-dose computed tomography; lung cancer; lung cancer screening; thoracic surgery
تواريخ الأحداث: Date Created: 20201007 Date Completed: 20210405 Latest Revision: 20210405
رمز التحديث: 20221213
DOI: 10.1016/j.jtcvs.2020.08.109
PMID: 33023746
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-685X
DOI:10.1016/j.jtcvs.2020.08.109