CT Follow-up Sufficient for Some Lung Nodules
Awareness of the indolent course of cancers that manifest in nonsolid nodules (NSNs) has been increasing, especially among those in which the NSN is solitary or dominant. New research adds support to findings showing that lung cancers that manifest as NSNs have an indolent course and can be managed with annual follow-up.
Rowena Yip, MPH, of the Icahn School of Medicine at Mount Sinai Medical Center in New York, and colleagues searched the National Lung Screening Trial (NLST) database to identify all participants with at least one NSN on CT scan with lung cancer as the cause of death documented by the NLST endpoint verification process.
Among the 26,722 NLST participants enrolled in the CT portion of the study, 2,534 (9.4 percent) had at least one NSN identified as a result of the screening. Among the 27 patients who died of lung cancer and had an NSN that manifested in the same lobe as the cancer, the cause of death was most likely because of another dominant solid or part-solid nodule.
“This report adds further support toward taking a conservative approach for annual follow-up for the management and treatment of NSNs, especially when they are solitary. Whereas some of these NSNs may become aggressive lung cancers over time, the changes in the nodule appearance can be documented with CT scans, which for now remains the best biomarker for cancer progression. The current evidence suggests they can be managed effectively by careful monitoring on an annual basis,” the authors write.
Web Extras
- Access the study, "Lung Cancer Deaths in the National Lung Screening Trial Attributed to Nonsolid Nodules," at pubs.rsna.org/doi/full/10.1148/radiol.201615233