Surgical Aspects of Treatment of the Lung Cancer Found in Low-Dose CT-Based Screenings

Background: Lung cancer is the leading cause of cancer-related death worldwide. Screening with low-dose computed tomography (LDCT) enables early detection of low-stage non-small cell lung cancer (NSCLC), increasing the chances of curative surgery. The aim of the present study was to analyze selected surgical aspects of treatment among patients diagnosed with NSCLC through LDCT-based screening in Szczecin, the first program of this kind in Poland. Methods: A group of 52 patients who were screened and operated on was compared with patients diagnosed and operated on outside the screening program during the same time period and a group of patients diagnosed and operated on prior to the screening program being implemented. Results: The screened population demonstrated a significantly higher frequency of stage IA cancer diagnosis, smaller tumor volume, more lobectomies, and fewer pneumonectomies compared with the other two groups. In addition, the waiting time for surgery was shorter, the duration of the procedure longer, and the length of hospitalization was reduced among the screened patients. No significant differences were observed in postoperative mortality or perioperative complications. Adenocarcinoma occurred significantly more often in the screened population than in the other groups, and tumors were more frequently classified as grade G2. A significant correlation was found between the need for blood transfusion and the occurrence of perioperative complications. Conclusions: The implementation of an LDCT-based screening program for lung cancer has a significant impact on the workload and case profile of thoracic surgery departments. Several aspects of surgical treatment differ significantly between patients diagnosed through screening and patients diagnosed outside of the program.