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Observation subsolidnymi nodes and treatment of lung cancer

24 July 2018 13:39

Subsolidnye pulmonary nodes (SSN) can be considered as a risk biomarker for lung cancer. SSN conservative management could reduce the occurrence of unnecessary surgical intervention and over-treatment in some patients with multiple co-morbidities and aggressive lung cancer.

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Lung cancer - the main cause of death associated with cancer. Typically, symptoms begin to appear at the late stages of cancer. Conducting low-dose computed tomography (NMCT) reveals the tumor and to begin treatment in the early stage - this reduces patient mortality. Nevertheless, there are limitations NMCT: anomaly detection, non-cancerous, requiring additional testing, as well as diagnosis and treatment of malignant tumors, which do not affect the life expectancy of patients. Excessive treatment is often seen in slow-growing lung adenocarcinoma arising in the SSN. Unfortunately, resection of lung nodes subsolidnyh clinically advantageous and can lead to cardio-pulmonary damage in patients with concomitant diseases.

A group of European researchers assessed lung disease and associated risk of cancer deaths in patients with non subsolidnymi remote sites over a 10 year period, and also analyzed whether the cancer originated from these nodes. The aim of the study was to determine the long-term clinical outcomes in these patients by screening.

In 2005, during the screening studies Multicenter Italian Lung Detection compared the results of observations of patients with SSN and patients undergoing resection of early SSN. A new study based on data from 2303 patients randomized to NMCT Multicenter Italian Lung Detection. Patients with SSN were selected by visual analysis and computer CAD diagnosis. All subsolidnye nodes were classified as partially solid (PSN) and undignified (NSN). Scientists measured their volume by means of a semi-automatic segmentation. The risk of total mortality and mortality from lung cancer was tested in the Cox proportional hazards model.

The findings are published in the «Journal of Thoracic Oncology» magazine. A total of 5541 scientists discovered node at 55.5% (1277 of 2303) of patients screened. In 16.9% of patients (389 of 2303) subsolidnye nodules were found. Thirty cancer cases were diagnosed in patients with these nodules, reflecting the overall risk (7.7%) for diagnosis of disease 9.3 ± 1.2 years of observation and the risk ratio (6.77). Lung cancer is not paced from SNN, it was fixed in 22/30 (73%) patients with SNN. The ratio of mortality risk of cancer was 3.80 for patients with SNN, compared with patients without pulmonary nodules. Lung cancer caused SNN, was not the cause of death during the observation period at 100% of patients compared with 63.6% of patients whose cancer has not descended from SNN.

"The majority of subjects with subsolidnymi nodes, diagnosed with lung cancer, cancer appeared in other parts of the lungs. Cancers arising from SNN, never caused the death of the patients over a 10-year follow-up. Subsolidnye nodules can be regarded as a biomarker of cancer, and their development should be monitored for as long as there is a growth of a solid cancer component. This approach will reduce the occurrence of unnecessary surgery "- reported the scientists.

Source: https://medicalxpress.com/news/2018-07-surveillance-lung-subsolid-nodules-unnecessary.html


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