How common are benign surgeries after lung cancer screening?

Sunday, November 26 | 1:40 p.m.-1:50 p.m. | S4-SSCH02-5 | Room N228 

At least 15% of surgeries after lung cancer screening are performed on benign lesions, a study to be presented Sunday afternoon has found.

Lung cancer screening with low-dose computed tomography (LDCT) reduces lung cancer deaths, but it does produce some measure of false-positive results, explained a team led by Raquelle El Alam, MD, of the American University of Beirut in Lebanon. The group sought to measure the rate of surgery for benign nodules as well as determine tumor characteristics via research that included lung cancer screening data from 9,050 patients who underwent LDCT between May 2015 and October 2021.

El Alam and colleagues reviewed pathology reports and patient follow-up to determine whether identified nodules were benign or malignant, and they included only benign nodules in their research. They also tracked Lung-RADS category, nodule status, and FDG uptake on PET/CT.

Of the total patient cohort, 260 had surgery for a suspicious lung nodule, the team noted. Pathology reports indicated 220 lung cancers (85%), two other malignancies (1%), and 38 benign nodules (15%). Of the benign nodules, 12 consisted of scarring or fibrosis, five of benign neoplasms, 14 of infection or inflammation, and seven with other diagnoses. Lung-RADS categories consisted of the following:

• Four (11%) Lung-RADS 2
• Two (5%) Lung-RADS 3
• 11 (29%) Lung-RADS 4A
• 13 (34%) Lung-RADS 4B
• Eight (21%) Lung-RADS 4X

The bottom line? Surgical resection of benign nodules does happen, despite the application of Lung-RADS guidelines.

“Surgeries for benign pulmonary nodules are an inevitable part of a lung cancer screening program due to overlap between the appearance of benign and malignant pulmonary nodules,” the group concluded.

Attend this talk on Sunday to get all of the details.