The role of radiological and clinical findings in determining lobectomy decision in patients with undiagnosed resectable lung lesions

Abstract

Background: The aim of this study was to evaluate the role of radiological and clinical findings in determining lobectomy decision in undiagnosed resectable lung lesions. Methods: Between January 2014 and April 2023, a total of 135 patients (114 males, 21 females; mean age: 60.8±11.5 years; range, 17 to 84 years) who underwent lobectomy or wedge resection based on clinical and radiological data were retrospectively analyzed. Patients with undiagnosed lung lesions, whose diagnosis could not be confirmed through transthoracic fine needle aspiration biopsy or bronchoscopic endobronchial ultrasound, were included in the study. Clinical data including age, sex, smoking status, history of extrapulmonary cancer, family history of lung cancer, and presence of chronic obstructive pulmonary disease/idiopathic pulmonary fibrosis were noted. Radiological data including lesion size, margin characteristics, internal structure of the lesion, relationship of the lesion with surrounding tissues, and nuclear imaging results were also recorded. Results: Malignant lesions were detected in 74 patients, while benign lesions were detected in 61 patients. Comparing benign and malignant lesions, age, lesion size, lesion localization, presence of pleural retraction, and moderate-to-high maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography were found to be correlated with malignancy. Conclusion: The accurate assessment of lung lesions and prompt identification of possible malignancy are of paramount importance for implementing appropriate treatment strategies.