Radiologic Features, Staging, and Operability of Primary Lung Cancer in the Western Cape, South Africa A 1-Year Retrospective Study

Introduction: This retrospective study was performed to evaluate the radiologic features, staging, and resectability of lung cancer at the time of presentation in patients from the Western Cape of South Africa. Method: We included all patients with primary lung cancer reviewed during a 12- month period (January 2009 to December 2009) who had a definite tissue diagnosis and whose staging computed tomography scans were available. Fifteen radiologic parameters were assessed. Results: Data were complete in 204 patients. The proportion and median size of the various histologic subtypes were as follows: adenocarcinoma 53.9%, 53.4 mm; squamous cell 25.9%, 80.2 mm; small cell 14.2%, 80.8 mm; large cell 2.4%, 74.2 mm; bronchioloalveolar carcinoma 1.5%, 50.0 mm; and others 2%, 57.6 mm, respectively. The overall median size of tumor was 61.5 mm. Tumors were located centrally in 43.6%, peripherally in 46.6%, indeterminate in 9.8%, mediastinal in 11.3%, right lung in 53.4%, and in the left lung in 35.3%. Tuberculosis-related lung fibrosis was present in 16%, but only 5.4% patients had coexisting tumor and fibrosis at the same site. We observed no difference in the proportion of coexisting fibrosis between adenocarcinoma and squamous carcinoma. Only 16.2% of the patients were potential candidates for radical treatment, with an actual resection rate of 4.4%. Conclusions: In the Western Cape, adenocarcinoma is the commonest histologic subtype of bronchogenic carcinoma. Most patients present with late-stage primary tumors, and the percentage of patients with potentially resectable cancer is much lower than in Europe.