Pulmonary nodules resected at video-assisted thoracoscopic surgery: Etiology in 426 patients

PURPOSE: To determine the etiology of pulmonary nodules resected at video-assisted thoracoscopic surgery (VATS) and establish the probabilities that single or multiple nodules resected at VATS represent malignancy in patients with or Patients without known cancer. MATERIALS AND METHODS: Pathology reports from VATS performed between January 1995 and July 1997 were searched for data on gross specimens revealing pulmonary nodules 3 cm or smaller. Findings were correlated with clinical and histologic data. RESULTS: In 254 patients with one nodule resected at VATS,the nodules were malignant in 108 patients with and in 32 patients without known cancer (P <.03). Among 172 patients with multiple nodules resected, at least one nodule was malignant in 85 patients with and in 20 patients without known cancer (P >.05). Nodules larger than 1 cm were more likely to be malignant than were smaller nodules (P <.002). In patients with known malignancy nodules smaller than 0.5 cm were more likely to be benign, whereas nodules larger than 0.5 cm but smaller than 1 cm were more likely to be malignant (P <.001). CONCLUSION: A single pulmonary nodule resected at VATS was more likely to be malignant in patients with known cancer. Nodules larger than 1 cm but smaller than 3 cm resected at VATS were more likely to be malignant. Nodules Smaller than 0.5 cm were more likely to be benign.