Purpose: To determine the frequency of extrathoracic metastases in T1 non-s
mall-cell lung cancer.
Method: Ninety patients with T1 lung cancer identified on CT were included.
Extrathoracic metastases were evaluated at the time of initial diagnosis a
nd during a 1-year follow-up study. The frequency of metastases was compare
d in terms of cell type (squamous or nonsquamous), size (<2 cm or >2 cm), a
nd the initial CT findings of the tumor.
Results: Extrathoracic metastases were identified in 12 (13%) of 90 patient
s at the time of diagnosis and in 10 patients at the 1-year follow-up study
(total, 22 of 90 [24%] patients). Tumors with ground-glass opacity on CT w
ere associated with a significantly lower prevalence of metastases (p = 0.0
42). The area of ground-glass opacity was seen in 11 of 13 (85%) patients w
ith bronchioloalveolar carcinoma and in 12 of 53 (23%) patients with adenoc
arcinoma other than bronchioloalveolar carcinoma (p < 0.001). There was no
significant difference in the prevalence of metastases between squamous and
nonsquamous cell carcinoma, between tumors smaller than 2 cm (n = 17) and
larger than 2 cm in diameter(n = 73) and between tumors with or without med
iastinal nodal metastases (p > 0.05).
Conclusion: Extrathoracic metastases were apparent at the initial examinati
on in 13% of patients and at the 1-year follow-up examination in 11% of pat
ients. The prevalence is significantly lower in tumors with ground-glass op
acity.