title: Outcomes of synchronous pulmonary nodules detected on computed tomography in head and neck cancer patients: 12-year retrospective review of a consecutive cohort.
abstract: OBJECTIVE
  To investigate the long-term outcomes of pulmonary nodules detected on chest computed tomography in a consecutive cohort of patients with newly diagnosed or recurrent head and neck squamous cell cancer staged between 2001 and 2003.
  
  
  RESULTS
  The study included 222 patients, 148 patients with newly diagnosed head and neck cancer (group 1) and 74 patients with recurrent cancer (group 2). Abnormalities were identified in 101 patients (45.4 per cent); these were predominantly benign in group 1 (61.7 per cent) as compared to predominantly malignant in group 2 (64.3 per cent) (Fisher's exact test; p = 0.0009). Only four patients (7.4 per cent) with an initially benign-looking pulmonary nodule went on to develop malignancy over time, conferring a negative predictive value of 93 per cent for the whole cohort.
  
  
  CONCLUSIONS
  Chest computed tomography abnormalities in patients with recurrent head and neck cancer are statistically more likely to be malignant. Very few patients with an initially benign-appearing nodule develop chest malignancy over time.
authors.affiliation: Department of Radiology,Newcastle upon Tyne Hospitals NHS Foundation Trust,Newcastle upon Tyne,UK.
authors.forename: I
authors.initials: I
authors.lastname: Zammit-Maempel
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery,Newcastle upon Tyne Hospitals NHS Foundation Trust,Newcastle upon Tyne,UK.
authors.forename: R
authors.initials: R
authors.lastname: Kurien
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery,Newcastle upon Tyne Hospitals NHS Foundation Trust,Newcastle upon Tyne,UK.
authors.forename: V
authors.initials: V
authors.lastname: Paleri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D004739:England / Q000453:epidemiology; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D033162:Incidental Findings; D007249:Inflammation; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000453:epidemiology; D010995:Pleural Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed
keywords: Chest; Computerized Tomography; Head And Neck Cancer; Multiple Pulmonary Nodules; Prognosis; Pulmonary Nodules; Solitary; X-Ray