Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-23T23:55:09.611Z Has data issue: false hasContentIssue false

Outcomes of synchronous pulmonary nodules detected on computed tomography in head and neck cancer patients: 12-year retrospective review of a consecutive cohort

Published online by Cambridge University Press:  15 March 2016

I Zammit-Maempel*
Affiliation:
Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
R Kurien
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
V Paleri
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
*
Address for correspondence: Dr Ivan Zammit-Maempel, Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK Fax: 0191 223 1168 E-mail: ivan.zammit@nuth.nhs.uk

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.

Conclusion:

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 McLeod, NM, Jess, A, Anand, R, Tilley, E, Higgins, B, Brennan, PA. Role of chest CT in staging of oropharyngeal cancer: a systematic review. Head Neck 2009;31:548–55Google Scholar
2 Jones, AS, Morar, P, Phillips, DE, Field, JK, Husband, D, Helliwell, TR. Second primary tumors in patients with head and neck squamous cell carcinoma. Cancer 1995;75:1343–53Google Scholar
3 León, X, Quer, M, Diez, S, Orús, C, López-Pousa, A, Burgués, J. Second neoplasm in patients with head and neck cancer. Head Neck 1999;21:204–103.0.CO;2-7>CrossRefGoogle ScholarPubMed
4 Halpern, J. The value of chest CT scan in the work-up of head and neck cancers. J Med 1997;28:191–8Google Scholar
5 Bisase, B, Kerawala, C, Lee, J. The role of computed tomography of the chest in the staging of early squamous cell carcinoma of the tongue. Br J Oral Maxillofac Surg 2008;46:367–9Google Scholar
6 Tan, BB, Flaherty, KR, Kazerooni, EA, Iannettoni, MD; American College of Chest Physicians. The solitary pulmonary nodule. Chest 2003;123:8996S CrossRefGoogle ScholarPubMed
7 MacMahon, H, Austin, JH, Gamsu, G, Herold, CJ, Jett, JR, Naidich, DP et al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 2005;237:395400 Google Scholar
8 Loh, KS, Brown, DH, Baker, JT, Gilbert, RW, Gullane, PJ, Irish, JC. A rational approach to pulmonary screening in newly diagnosed head and neck cancer. Head Neck 2005;27:990–4CrossRefGoogle ScholarPubMed
9 De Bree, R, Deurloo, EE, Snow, GB, Leemans, CR. Screening for distant metastases in patients with head and neck cancer. Laryngoscope 2000;110:397401 Google Scholar
10 Arunachalam, PS, Putnam, G, Jennings, P, Messersmith, R, Robson, AK. Role of computerized tomography (CT) scan of the chest in patients with newly diagnosed head and neck cancers. Clin Otolaryngol 2002;27:409–11Google Scholar
11 Ghosh, SK, Roland, NJ, Kumar, A, Tandon, S, Lancaster, JL, Jackson, SR et al. Detection of synchronous lung tumors in patients presenting with squamous cell carcinoma of the head and neck. Head Neck 2009;31:1563–70Google Scholar
12 Hsu, Y-B, Chu, P-Y, Liu, J-C, Lan, M-C, Chang, S-Y, Tsai, T-L et al. Role of chest computed tomography in head and neck cancer. Arch Otolaryngol Head Neck Surg 2008;134:1050–4Google Scholar
13 Beech, TJ, Coulson, C, Najran, P, Olliff, J, Jennings, C. How good is a chest CT scan at predicting the risk of pulmonary metastatic disease in patients with head and neck cancer? A retrospective observational study. Clin Otolaryngol 2010;35:474–8Google Scholar
14 Edey, AJ, Hansell, DM. Incidentally detected small pulmonary nodules on CT. Clin Radiol 2009;64:872–84CrossRefGoogle ScholarPubMed