Macmillan MT, Hopkins M, Gomati A, Subedi D, Reid H, Bruce L, Murchison JT, Nixon IJ. Analysis of the interactions between small pulmonary nodules, clinical factors and the risk of malignancy in the chest following diagnosis of head and neck cancer.
Clin Otolaryngol 2022;
47:455-463. [PMID:
35212150 DOI:
10.1111/coa.13922]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/18/2022] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND
This study aims to investigate radiological and clinical factors which predict malignancy in indeterminate pulmonary nodules in patients with head and neck cancer (HNC).
METHODS
Prospective data was collected in 424 patients who were reviewed in the NHS Lothian HNC multi-disciplinary meeting from May 2016 to May 2018. Staging and follow up CT chest imaging was reviewed to identify and assess pulmonary nodules in all patients.
RESULTS
61.8% of patients had at least one pulmonary nodule at staging CT. In total 25 patients developed malignancy in the chest. Metastatic disease in the chest was significantly associated with unknown or negative p16 status (p<0.0005). Pleural indentation and spiculation were associated with indeterminate nodules, subsequently being shown to represent metastatic disease (p>0.0005 and p=0.046 respectively).
CONCLUSION
Negative or unknown p16 status was associated with an increased propensity to develop metastatic disease in the chest in patients with HNC.
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