Does every necrotizing granulomatous inflammation at NSCLC resection materials require treatment?

Abstract

OBJECTIVE: Lung cancer and tuberculosis (TB) are two major public health problems. They can coexist or appear sequentially. In patients with TB, lung cancer risk is increased. However, vice versa is not crystal clear. In this study, we aimed to determine the development of TB in patients with resectable nonsmall cell lung cancer (NSCLC) in a 2 year postoperative window. PATIENTS AND METHOD: We conducted a cross sectional study at 3 university hospitals. Patients who had NSCLC surgery between 2009 and 2013 were screened for presence of necrotizing granulomatous inflammation (NGI). Demographic properties, tumor type, stage, location, type of surgery, tuberculosis history and thorax CT findings were recorded. We have searched for development of tuberculosis within 2 year period after surgery. RESULTS: A total of 1027 files were screened and 48 patients had NGI. Median age was 63. Most common type of cancer was squamous carcinoma and lobectomy was the preferred operation (70.8%). Cancer involvement of the right lung (61,8%) and upper lobes were more common (47,9%). Only 11 patients had antituberculosis treatment postoperatively depending on radiological findings. Prior tuberculosis or antituberculosis history, type, stage or localization of cancer, adjuvant/neoadjuvant therapy were not related with treatment. None of the study population had tuberculosis during follow up period. DISCUSSION/CONCLUSION: Treatment decisions were mostly related with physicians own experiences. There was no difference at the risk of TB development in between patients with or without treatment. Every NGI at NSCLC resection material dose not always require antituberculosis treatment.