title: Clinical significance of indeterminate pulmonary nodules in patients with locally advanced head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The purpose of this study was to determine whether indeterminate pulmonary nodules (IPNs) at staging are predictive of lung metastasis, primary lung carcinoma, or survival in patients with advanced head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  One hundred ten patients with IPN at staging who had follow-up imaging and 100 patients without IPN were identified from an HNSCC database. The primary endpoints were lung progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  Two-year lung PFS for the IPN and No-IPN cohorts were 66% versus 61% (p = .92) and the OS for these cohorts were 71% versus 68% (p = .77). Within the IPN cohort, level IV/V lymph node involvement (odds ratio = 4.34; p = .03), hypopharynx primary (odds ratio = 21.5; p = .005), and race (odds ratio = 9.29; p = .001) were independent predictors of developing lung malignancy.
  
  
  CONCLUSIONS
  IPNs at staging in patients with HNSCC do not affect prognosis and should neither influence initial treatment planning nor the frequency of posttreatment surveillance.
authors.affiliation: Department of Radiology, University of North Carolina Hospitals, Chapel Hill, North Carolina.
authors.forename: Raphael E
authors.initials: RE
authors.lastname: Alford
authors.forename: David V
authors.initials: DV
authors.lastname: Fried
authors.forename: Benjamin Y
authors.initials: BY
authors.lastname: Huang
authors.forename: Mark
authors.initials: M
authors.lastname: Weissler
authors.forename: Carol
authors.initials: C
authors.lastname: Shores
authors.forename: William
authors.initials: W
authors.lastname: Shockley
authors.forename: Trevor
authors.initials: T
authors.lastname: Hackman
authors.forename: Adam
authors.initials: A
authors.lastname: Zanation
authors.forename: Neil
authors.initials: N
authors.lastname: Hayes
authors.forename: Jared
authors.initials: J
authors.lastname: Weiss
authors.forename: Juneko
authors.initials: J
authors.lastname: Grilley-Olson
authors.forename: Valerie
authors.initials: V
authors.lastname: Jewells
authors.forename: Katherine
authors.initials: K
authors.lastname: Birchard
authors.forename: Bhishamjit S
authors.initials: BS
authors.lastname: Chera
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000175:diagnosis* / Q000556:secondary*; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
keywords: metastasis; multiple pulmonary nodules; solitary pulmonary nodule; squamous cell carcinoma of the head and neck; surveillance