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.