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

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PURPOSEPulmonary 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. METHODSIt 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, iii) whether hamartoma was a predictive factor for lung cancer development RESULTSOur 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 after diagnosis 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 cancer development on logistic regression analysis. CONCLUSIONSSurgical resection of hamartoma is a safe procedure; recurrence and malignant degeneration are very uncommon and the association between hamartoma and lung cancer seems to be a spurious phenomenon.