Xuan Xie, Ke Jin, Huizhong Zhang, Minghui Wang, Ju Chen, Xuan Xie

Thoracic surgery, Sun Yat-sen memorial hospital

Objective:Defining the status of single lung lesion and making treatment strategy was intricate, and had been well studied for decades. However, seldom studies had focused on this issue in patients with history of previous malignancy. The aim of this study was to present the properties of single pulmonary lesions in these patients, and to seek the possible factors relating to the status of these lesions. Method: This cross-sectional study included 110 patients with single lung lesion and previous malignancy, who underwent surgical resection between February 2005 and February 2015 at Sun Yat-sen Memorial Hospital. Univariate and multivariate analyses were performed to identify factors affecting characteristics of the single lung lesion. Result: The metastatic tumors, primary lung cancers and benign lesions were found in 64 (58.2%), 39 (35.5%) and 7(6.4%) pateints, respectively. Univariate analysis revealed the smoking status (P=0.021), primary tumor (P<0.01), lymph node status of primary tumor (P<0.01), site of lung lesion (P=0.001) and adjuvant therapy (P=0.001) were the possible factors relating to the properties of single lung lesions. However, only positive lymph node status of primary tumor (95% confidenceinterval [CI], 0.056-0.574; P=0.0004) and peripheral site of lung lesion (95% CI, 0.029-0.716; P=0.018) were independently correlated with a matastatic tumor in multivariate analysis. In a subgroup analysis of 76 solitary lung nodules ≤ 3cm, peripheral pulmonary lesion (95% CI, 0.004-0.0.632; P=0.021) and positive lymph nodes status of primary tumor (95% CI, 0.041-0.790; P=0.023) sustained their significances indicating intrapulmonary metastases. Conclusion: The incidence of single lung malignant lesion in patients with history of previous malignancy was fairly high. A positive lymph nodes status of primary malignancy and peripheral lung lesion might indicate an intrapulmonary metastasis, rather than a primary lung cancer.

Key Words: single lung lesion  previous malignancy  status