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J Thorac Cardiovasc Surg 2002;124:221-222
© 2002 The American Association for Thoracic Surgery

Editorials

High-resolution computed tomography in clinical T1 N0 M0 adenocarcinoma of the lung

From the Memorial Sloan-Kettering Cancer Center, New York, NY.

Received for publication Jan 15, 2002. Accepted for publication Feb 22, 2002. Address for reprints: Valerie W. Rusch, MD, Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021 (E-mail: ruschv@mskcc.org).

The first 20% of the full text of this article appears below.

	Introduction

 
See related article on page 278.

Despite much controversy surrounding the effectiveness of low-dose helical computed tomographic (CT) scanning for the early detection of lung cancer, ¹ the use of CT for this purpose is already widespread and is rapidly changing clinical practice. Radiologists and thoracic surgeons are confronted with the need to distinguish tiny benign pulmonary lesions from very early lung cancers and with the challenge of determining when biopsy or resection is appropriate. However, there are no absolute criteria for identifying very early lung cancers on CT or for determining preoperatively the clinical and biologic behavior of an individual tumor.

The widespread use of CT scanning is also challenging our approach to pulmonary resection. Lobectomy has been the standard form of resection for most lung cancers, based in part on a randomized trial by the Lung Cancer Study Group showing that lesser resections were associated with a significantly higher risk of local recurrence. ² Now the increasing diagnosis of very early lung cancers—usually defined as T1a tumors that are 2 cm or less in size—is leading thoracic surgeons to question . . . [Full Text of this Article]

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J. Thorac. Cardiovasc. Surg. 2002 124: 278-284. [Abstract] [Full Text] [PDF]

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