Surgical Outcomes in a Lung Cancer-Screening Program Using Low Dose Computed Tomography.

Area of Science:

• Oncology
• Thoracic Surgery
• Radiology

Background:

• Lung cancer (LC) is a leading cause of cancer death globally, with many cases in Spain diagnosed at unresectable stages.
• Early detection and timely treatment are crucial for reducing LC mortality.
• A longstanding lung cancer screening (LCS) program in Spain utilizes low-dose computed tomography (LDCT).

Purpose of the Study:

• To describe the surgical outcomes within a well-established LC screening cohort in Spain.
• To evaluate the effectiveness of LDCT-based screening in identifying operable lung cancers.
• To analyze the morbidity, mortality, and survival associated with surgical treatment of screen-detected lung cancers.

Main Methods:

• A retrospective analysis of surgical outcomes in an LCS program using LDCT since 2000.
• Descriptive analysis of clinical, radiological, and pathological data, including preoperative diagnosis, staging, complications, and survival.
• Evaluation of 87 surgical procedures for suspected or biopsy-proven LC detected by LDCT.

Main Results:

• Ninety-seven lung cancers (2.5%) were diagnosed in 3825 screened individuals.
• Eighty-seven surgical procedures were performed; most patients were male (85%), aged 64±9.1 years, with a mean tumor size of 15.2±7.6mm.
• Stage I lung cancer (88%) was most common, with adenocarcinoma (58.2%) being the predominant histology. Five- and 10-year survival rates for stage I were 93% and 83%, respectively.

Conclusions:

• Lung cancer screening using LDCT is associated with excellent surgical outcomes.
• High survival rates (5-year >90%, 10-year >80%) were achieved for stage I lung cancer detected through screening.
• The findings support the efficacy of LCS programs in improving survival for lung cancer patients.