Spectrum of Benign and Malignant Diseases in Patients Operated at A Tertiary Care Thoracic Surgery Center

Abstract

Objective: Thoracic surgery addresses a wide range of benign and malignant conditions, and understanding their epidemiological patterns is vital for effective healthcare planning, particularly in low- and middle-income countries. This study aimed to determine the frequency and spectrum of thoracic diseases among surgically managed patients at a major tertiary care center in Pakistan. Methods: A prospective observational study was conducted in the Department of Thoracic Surgery at Jinnah Postgraduate Medical Center (JPMC), Karachi. Histopathological records of patients who underwent thoracic surgical procedures between 2018 and 2024 were reviewed. A total of 286 biopsy specimens fulfilling the inclusion criteria were analyzed. Data were collected using structured questionnaires and analyzed using the Statistical Package for the Social Sciences (SPSS). Results: Malignant pathologies constituted a substantial proportion of thoracic diseases. Esophageal squamous cell carcinoma was the most common malignancy, representing 79% of esophageal biopsies, with a notable female predominance. Lung squamous cell carcinoma accounted for 20% of pulmonary biopsies and was strongly associated with smoking. Common benign conditions included bronchiectasis (20%), hydatid cysts (16%), and pleural tuberculosis (50%). Chest wall malignancies, such as Ewing’s sarcoma and chondrosarcoma, comprised 50% of cases, while small cell carcinoma was the most frequent mediastinal malignancy (36.4%). Conclusion: The study demonstrates a significant burden of thoracic malignancies and benign diseases in Pakistan. The high prevalence of esophageal and lung cancers highlights the need for enhanced diagnostic capabilities, early detection programs, and targeted public health interventions. Strengthening thoracic surgical services and conducting larger epidemiological studies are essential for improving patient outcomes.