Possibilities of computer assisted tomography (CT) in evaluation of lung cancer operability

As is well known, surgical treatment is the most effective therapy for non-small cell lung cancer, although only a small number of patients are suitable for this type of treatment (25%-30%). The outcome of operative treatment and prognosis greatly depends on accurate preoperative diagnostic process using the TNM classification. Until now, different diagnostic methods are used in the preoperative staging of this severe illness, including computer assisted tomography which acquired a leading role. Despite its high value as a method of assessing the operability of lung cancer, there is a smaller percentage of diagnostic oversights where the stage was under or over-estimated and where discrepancy between CT and operative findings was present. Prospective study was conducted on 60 patients with lung cancer in the period from December 2000 to December 2007. Among our respondents there were more males (6.5:1), average age was 56; the youngest patient was 32 and the oldest 70 years old. All patients underwent complete pulmonary and bronchial CT examination and then were subjected to one of the surgeries (28 lobectomies, 15 pneumectomy and 17 exploration thoracotomy) with pathohistological verification of findings. CT and postoperative lung cancer results were compared and statistically processed using the usual statistical methods. The results show that CT as a method in the preoperative clinical evaluation of patients with lung cancer is very useful because of its high diagnostic accuracy in determination of TNM stages of disease (83.33% accuracy, sensitivity 76.40%, specificity 93.00%, PPV 90.90% and 81.25% NPV). CT of thoracic organs still remains irreplaceable method in everyday clinical treatment of patients with lung cancer.