Between the years 1964-1976, 67 patients with solitary pulmonary nodules underwent operation. 67% of the nodules were malignant and 33% benign. The most frequent malignant lesions were bronchogenic carcinoma and metastatic lesions. Hamartoma was the most frequent benign lesion. The youngest patient with a malignant lesion was 32 years old. The frequence of asymptomatic patients and of patients whose lesion was discovered at routine examination was higher among those with benign lesions. About 3/4 of the benign lesions were smaller in diameter than 3 cm, but 60% of the malignant lesions were about this diameter. The percentage of non-smokers was the same in the benign and the malignant groups. 71% of the patients with malignant lesions had a curative operation and only one patient underwent exploratory thoracotomy alone. Two patients died in the postoperative period. Both were above the age of 69 and had malignant tumors. The 5-year survival rate for all patients was 24%. Among those with malignant disease, it was 38% among females and 15% among males. The prognosis was better when the patient was under 59 years, when there were no symptoms, when the nodule was discovered at routine examination, when there was a curative operation, and in women with bronchogenic carcinoma. The authors believe that every patient over the age of 20 years with a pulmonary nodule who presents an acceptable surgical risk and in whom there is no proof that the lesion is benign, should be operated on as soon as possible. The other patients should undergo serial X-ray examinations to be sure that the nodule is not growing.
|State||Published - 1978|