Computed tomography of the chest in T1NoMo non-small cell bronchial carcinoma

There has been controversy within the recent literature as to the value of computed tomography (CT) of the chest in patients with T1NoMo non-small cell bronchial carcinoma, as staged by plain radiography and bronchoscopy. This paper reports on 63 such patients, nine (14.2%) of whom were shown correctly by CT of the chest to have metastatic spread which rendered them inoperable. Of these nine, four had stage N3 mediastinal disease; the other five had metastatic disease, either pulmonary or bony. Patients with lesions less than 2 cm in diameter were also looked at separately: 4/20 had inoperable disease on CT of the chest. In both groups the detection rate of inoperability by CT of the chest justifies its use pre-operatively in all T1NoMo non-small cell bronchial carcinomas, in terms of clinical morbidity, mortality and cost.