The clinical relevance of indeterminate lung nodules in patients with locally recurrent rectal cancer |
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| Institution: | 1. Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;2. Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;3. Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;4. Department of Radiology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;1. CRUK Southampton Centre/ Cancer Sciences, University of Southampton, Somers Building, Southampton General Hospital, Southampton, SO16 6YD, UK;2. Human Health and Development, University of Southampton, IDS Building, Southampton General Hospital, Southampton, SO16 6YD, UK;3. Division A, University Hospitals Southampton NHS Trust, Southampton General Hospital, Southampton, SO16 6YD, UK;1. Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea;2. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;3. Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea;4. Department of Surgery, Hallym University College of Medicine, Anyang, Republic of Korea;5. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea;1. Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada;2. Division of General Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada;3. Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada;4. Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TH, UK;1. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;2. Department of Gastric Surgery, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, China;3. Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;4. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China;5. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union College, Beijing, China;6. Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi’an, China;7. Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;8. Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;9. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China;10. Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing, China;11. Department of General Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, China |
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| Abstract: | AimTo evaluate the clinical relevance of indeterminate lung nodules (ILN) in patients with locally recurrent rectal cancer (LRRC) treated in a tertiary referral centre.MethodsAll patients with LRRC diagnosed between 2000 and 2017 were retrospectively reviewed. Reports of staging chest CT-scans were evaluated for ILN. Patients with distant metastases including lung metastases at time of LRRC diagnosis were excluded. Overall (OS), progression-free survival (PFS) and the cumulative incidence of lung metastases were compared between patients with and without ILN.ResultsIn total 556 patients with LRRC were treated during the study period. In the 243 patients eligible for analysis, 68 (28%) had ILN at LRRC diagnosis. Median OS was 37 months for both the patients with and without ILN (p = 0.37). Median PFS was 14 months for the patients with ILN and 16 months for patients without ILN (p = 0.80). After correction for potential confounding, ILN present at LRRC diagnosis was not associated with impaired OS or PFS (adjusted hazards ratio 95% confidence interval]: 0.81 0.54–1.22] and 1.09 0.75–1.59]). The 5-year cumulative incidence of lung metastases was 31% in patients with ILN and 28% in patients without ILN (p = 0.19).ConclusionOur study shows that ILN are present in roughly a quarter of patients with LRRC. No differences in OS, PFS, or the cumulative incidence of lung metastases were found between patients with and without ILN at LRRC diagnosis. These results suggest that ILN are of little to no clinical relevance in patients with LRRC. |
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| Keywords: | Locally recurrent rectal cancer Chest computed tomography Indeterminate lung nodules Lung metastases |
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