title: Indeterminate pulmonary nodules in patients with sarcoma affect survival.
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.
authors: Department of Radiology, Indiana University Hospital, Indianapolis, IN, USA.
authors: Stacy
authors: S
authors: Rissing
authors: Bruce T
authors: BT
authors: Rougraff
authors: Kenneth
authors: K
authors: Davis
mesh_terms: D000328:Adult; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary*; D008297:Male; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D015996:Survival Rate; D036542:Tomography, Spiral Computed