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

• Published in: Lung Vol. 199; no. 4; pp. 369 - 378
• Main Authors: Fiorelli, Alfonso, D’Andrilli, Antonio, Carlucci, Annalisa, Vicidomini, Giovanni, Argento, Giacomo, Trabalza Marinucci, Beatrice, Ardissone, Francesco, Rapanà, Roberta, Sobrero, Simona, Carbognani, Paolo, Ventura, Luigi, Bocchialini, Giovanni, Ragusa, Mark, Tassi, Valentina, Sollitto, Francesco, Loizzi, Domenico, Ardò, Nicoletta Pia, Anile, Marco, Puma, Francesco, Rendina, Erino Angelo, Venuta, Federico, Serra, Nicola, Santini, Mario
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2021; Springer; Springer Nature B.V
• Subjects: Aged; Analysis; Cancer; Cigarettes; Complications; Degeneration; Endoscopy; Enucleation; Hamartoma; Hamartoma - complications; Hamartoma - surgery; Health aspects; Humans; Lung; Lung cancer; Lung Neoplasms - complications; Lung Neoplasms - surgery; Medicine; Medicine & Public Health; Neoplasia; Oncology, Experimental; Pneumology/Respiratory System; Population studies; Pulmonary Hamartoma; Retrospective Studies; Risk analysis; Risk factors; Smokers; Smoking; Tumors; Surgical resection; Lung cancer; Pulmonary; Hamartoma
• DOI: 10.1007/s00408-021-00460-8
• EISSN: 1432-1750
• ISSN: 0341-2040

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.