Indeterminate pulmonary nodules in patients with sarcoma affect survival

Clin Orthop Relat Res. 2007 Jun:459:118-21. doi: 10.1097/BLO.0b013e31805d8606.

Abstract

We prospectively studied 331 sarcoma patients treated between April 1999 and December 2004 to see if small, indeterminate pulmonary nodules are of prognostic significance. Seventy-one (21%) had indeterminate pulmonary nodules on initial spiral CCT. Twenty of 71 (28%) patients with indeterminate nodules progressed with metastatic disease. Metastatic disease developed in 18/20 (90%) in the area of the original indeterminate nodule. The presence of tiny (<5 mm) indeterminate nodules was not a prognostic variable, however, the presence of nodules > or =5 mm was associated with worse 3 year disease-free survival compared to those with no nodules or tiny nodules (81% versus 49%) but better than those with definite metastatic disease at presentation (49% versus 5%). Because patients with pulmonary nodules > or =5 mm are at increased risk for metastatic disease compared to patients with normal CCT or those with <5 mm nodules but better survival than patients with Stage IV disease, we believe a new staging system of these patients should be considered and recommend careful followup.

MeSH terms

  • Adult
  • Child
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / mortality
  • Lung Neoplasms / secondary*
  • Male
  • Sarcoma / diagnostic imaging
  • Sarcoma / mortality
  • Sarcoma / pathology*
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Solitary Pulmonary Nodule / pathology
  • Survival Rate
  • Tomography, Spiral Computed