Clinical Significance of Incidental Pulmonary Nodules in Esophageal Cancer Patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-09-04

AUTHORS

Amin Madani, Jonathan Spicer, Thierry Alcindor, Marc David, Marie Vanhuyse, Jamil Asselah, David Mulder, Lorenzo Ferri

ABSTRACT

IntroductionIncidental pulmonary nodules are frequently identified during staging investigations for esophageal cancer patients. Their clinical significance is unclear and may bias treatment decisions towards palliative options.MethodsFrom 2005 to 2011, 423 esophageal cancer patients were treated at a tertiary hospital. Those with incidental pulmonary nodules were identified. Demographics, imaging, pathology and perioperative outcomes were analyzed.ResultsNinety-two patients (22 %) had lung nodules. Twenty-nine (32 %) were palliative due to poor performance status or extra-pulmonary distant metastasis on imaging. Sixty-three had no evidence of extra-pulmonary metastasis and underwent curative-intent treatment comprising of neoadjuvant therapy [35 (55 %)] followed by esophagectomy [with lung resection, 33 (52 %) or without lung resection, 30 (48 %)]. Of those 33 lung resections, there were 27 benign lesions, 4 stage I lung cancers, and 1 esophageal cancer metastasis. Of 30 patients with lung nodules that underwent curative esophagectomy without lung resection, none showed interval size increase on follow-up imaging [median 9 months (3–40)]. There was no difference in perioperative complications or mortality between patients with combined esophagectomy and lung resection and those with esophagectomy alone.ConclusionIncidental pulmonary nodules in the absence of extra-pulmonary metastases in esophageal cancer patients are rarely metastases and should not bias caregivers towards palliative therapy. More... »

PAGES

226-233

References to SciGraph publications

  • 2008-10-03. Continuing Rapid Increase in Esophageal Adenocarcinoma in England and Wales in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
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    http://scigraph.springernature.com/pub.10.1007/s11605-013-2339-6

    DOI

    http://dx.doi.org/10.1007/s11605-013-2339-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1053354340

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/24002773


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