Lung nodule surgery not always “futile”

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The gold standard for definitive diagnosis of a lung nodule is surgical removal (resection). However, between 10 percent and 30 percent of suspicious nodules are benign. Because thoracic operations are highly invasive and pose significant risks, these operations have been labeled “unnecessary” or “futile.”

Eric Grogan, assistant professor of thoracic surgery, and colleagues report that, even when surgical resection results in a benign diagnosis, the operation still provides significant benefits by providing a new diagnosis and/or change in treatment course. Out of 278 lung operations for known or suspected lung cancer performed by surgeons at Vanderbilt, 23 percent of cases had benign disease. Resection led to definitive diagnosis or treatment changes in 85 percent of cases. Despite the highly invasive procedure, in-hospital complications were rare and no deaths occurred.

The findings, reported in the October Journal of Thoracic Oncology, suggest that despite the invasive nature, operative resections for suspicious lung lesions often offer benefits to patients and carry minimal risk of complications or surgery-associated mortality.

The research was supported by grants from the National Cancer Institute and the National Center for Research Resources.