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Incidence of nodal and distant metastasis in patients with lung cancer manifesting as a subsolid nodule

Principal Investigator
Name
Jihang Kim
Degrees
M.D.
Institution
Seoul National University Bundang Hospital
Position Title
Clinical Fellow
Email
About this CDAS Project
Study
NLST (Learn more about this study)
Project ID
NLST-174
Initial CDAS Request Approval
Nov 2, 2015
Title
Incidence of nodal and distant metastasis in patients with lung cancer manifesting as a subsolid nodule
Summary
Current National Comprehensive Cancer Network (NCCN) guideline recommend pretreatment imaging work-up with PET/CT and brain MRI in patients with suspected lung cancer. However, recent studies show result that primary lung cancer manifesting as a subsolid nodule rarely metastasizes and further imaging work-up might be unnecessary. We aim to investigate the difference in the incidence of nodal or distant metastasis between solid and subsolid primary lung cancer in each clinical T staging estimated by maximum diameter on CT. If the result would be consistent with our assumption that primary lung cancer with low attenuation rarely develops nodal or distant metastasis, certain portion of additional preoperative imaging work-up could be considered unnecessary.
Aims

Primary lung cancer manifestating as a solitary pulmonary nodule will be classified into two categories by attenuation (Hounsfield unit); solid and subsolid primary lung cancer. Each group will be divided into size category according to American Joint Committee on Cancer (AJCC) 7th staging guideline of lung cancer. We will investigate the incidence of nodal and distant metastasis of each group of primary lung cancer. Also, within the group of lung cancer manifestating as a subsolid pulmonary nodule, we will investigate the outcome difference between subgroups with or without additional preoperative work-up such as brain MRI and PET/CT. If information is available, futile thoracotomy rate and justified thoracotomy rate would be compared between the subgroups.
Knowledge acquired from our study would hopefully help reduce unnecessary preoperative imaging work-up in patients with primary lung cancer manifesting as a subsolid pulmonary nodule.

Collaborators

Kyung Won Lee, Seoul National University Bundang Hospital
Kyung Hee Lee, Seoul National University Bundang Hospital