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Multicenter Study
. 2021 Aug;199(4):369-378.
doi: 10.1007/s00408-021-00460-8. Epub 2021 Jul 24.

Pulmonary Hamartoma Associated With Lung Cancer (PHALC Study): Results of a Multicenter Study

Alfonso Fiorelli  1 , Antonio D'Andrilli  2 , Annalisa Carlucci  3 , Giovanni Vicidomini  3 , Giacomo Argento  2 , Beatrice Trabalza Marinucci  2 , Francesco Ardissone  4 , Roberta Rapanà  4 , Simona Sobrero  4 , Paolo Carbognani  5 , Luigi Ventura  5 , Giovanni Bocchialini  5 , Mark Ragusa  6 , Valentina Tassi  6 , Francesco Sollitto  7 , Domenico Loizzi  7 , Nicoletta Pia Ardò  7 , Marco Anile  8 , Francesco Puma  9 , Erino Angelo Rendina  2 , Federico Venuta  8 , Nicola Serra  10 , Mario Santini  3
Affiliations
Multicenter Study

Pulmonary Hamartoma Associated With Lung Cancer (PHALC Study): Results of a Multicenter Study

Alfonso Fiorelli et al. Lung. 2021 Aug.

Abstract

Purpose: Pulmonary hamartoma is the most common benign tumor of the lung. We analyzed a 20-year historical series of patients with pulmonary hamartoma undergoing surgical resection, aiming to evaluate the characteristics, the outcomes, and the association between hamartoma and lung cancer.

Methods: It was a retrospective multicenter study including the data of all consecutive patients with pulmonary hamartoma undergoing surgical resection. The end-points were to evaluate: (i) the characteristics of hamartoma, (ii) outcomes, and (iii) whether hamartoma was a predictive factor for lung cancer development RESULTS: Our study population included 540 patients. Upfront surgical or endoscopic resection was performed in 385 (71%) cases while in the remaining 155 (29%) cases, the lesions were resected 20 ± 3.5 months later due to increase in size. In most cases, lung sparing resection was carried out including enucleation (n = 259; 48%) and wedge resection (n = 230; 43%) while 5 (1%) patients underwent endoscopic resection. Only two patients (0, 2%) had major complications. One patient (0.23%) had recurrence after endoscopic resection, while no cases of malignant degeneration were seen (mean follow-up:103.3 ± 93 months). Seventy-six patients (14%) had associated lung cancer, synchronous in 9 (12%) and metachronous in 67 (88%). Only age > 70-year-old (p = 0.0059) and smokers > 20 cigarettes/day (p < 0.0001) were the significant risk factors for lung cancer.

Conclusion: PH was a benign tumor, with no evidence of recurrence and/or of malignant degeneration after resection. The association between hamartoma and lung cancer was a spurious phenomenon due to common risk factors.

Keywords: Hamartoma; Lung cancer; Pulmonary; Surgical resection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
A 57-year-old woman had hamartoma and adenocarcinoma in the left lower lobe. She underwent thoracoscopy left lower lobectomy. Part A = CT scan; Part B and Part C = operative view of adenocarcinoma (B) and hamartoma (C)
Fig. 2
Fig. 2
Algorithm for decision making
See this image and copyright information in PMC

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