Lung resections in the lung screening of International Early Lung Cancer Action Program (IELCAP): 6 years of experience

Abstract

Screening programs (SP) with low-dose computed tomography (LDCT) have proven useful for early detection of and reducing mortality from lung cancer (LC). However, there are numerous publications on SP in LC, but aspects of surgery and its implications in this program are poorly reported. The aim of this paper was to present our experience in the surgical treatment of the LC patients in the SP study of the International Early Lung Cancer Action Program (IELCAP). Materials and Methods: The study was conducted with patients diagnosed with LC who underwent pulmonary resection in our hospital according to the IELCAP protocol. The study period covered September 2008 to December 2014, with a follow-up until November 2015. From each patient, the demographic, clinical and histology variables were collected prospectively. Results: Since the SP started in September 2008 and lasted to December 2014, 6,489 individuals were recruited. A hundred and four patients were diagnosed with LC. Eighty-three (79.8%) underwent surgery for lung resection. Fifty-three patients (63.8%) were classified as pathological stage IA. Twenty-one (25.3%) patients suffered 26 postoperative complications. The postoperative mortality of our series was 1.2%. The overall survival rate of specific cancer in the surgical series was 90.6% for stage I and 82% in general. Conclusion: Screening Program for LC with LDCT has allowed a change in staging LC diagnosis from advanced stages to earlier stages, and therefore surgical stage. This program reduces the rate of pneumonectomy and permits surgical treatment in early stages these advantages can imply reduce the mortality and morbidity of these patients.