Role of computed tomography in assessing "operability" of bronchial carcinoma

To try to assess the accuracy of predicting "operability" (as defined by local policy) of bronchial carcinoma 300 patients underwent computed tomography of the thorax in a prospective study. The results of 141 patients showed an agreement between computed tomographic and surgical (including pathological) findings in those patients who had received operations. Most of the other patients had more advanced disease than suggested by the findings of computed tomography. A total of 118 patients did not receive operations: in 47 their disease was considered to be inoperable on the basis of computed tomographic findings alone, and this was accepted by the cardiothoracic surgeons after consultation. Thirty two other patients had further evidence of metastatic disease on other investigations. Computed tomography of the thorax should be performed early in the assessment of operability of patients with bronchial carcinoma and before the start of an extensive search for metastatic disease.