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Clinical implications of nonspecific pulmonary nodules identified during the initial evaluation of patients with head and neck squamous cell carcinoma

  • Head and Neck
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Abstract

Objective

We aimed to identify the clinical implications of nonspecific pulmonary nodules (NPNs) detected in the initial staging workup for patients with head and neck squamous cell carcinoma (HNSCC).

Methods

Medical records of patients who had been diagnosed and treated in our hospital were retrospectively analysed. After definite treatment, changes of NPNs detected on initial evaluation were monitored via serial chest computed tomography. The associations between NPNs and the clinicopathological characteristics of primary HNSCC were evaluated. Survival analyses were performed according to the presence of NPNs.

Results

The study consisted of 158 (49.4%) patients without NPNs and 162 (50.6%) patients with NPNs. The cumulative incidence of probabilities of pulmonary malignancy (PM) development at 2 years after treatment were 9.0% and 6.2% in NPN-negative and NPN-positive patients, respectively. Overall and PM-free survival rates were not significantly different according to NPN status. Cervical lymph node (LN) involvement and a platelet-lymphocyte ratio (PLR) ≥126 increased the risk of PMs (both P <0.05).

Conclusions

NPNs detected in the initial evaluation of patients with HNSCC did not predict the risk of pulmonary malignancies. Cervical LN involvement and PLR ≥126 may be independent prognostic factors affecting PM-free survival regardless of NPN status.

Key Points

• We aimed to identify the clinical implications of nonspecific pulmonary nodules (NPNs).

• NPNs in head and neck cancer patients do not lead to pulmonary malignancies (PMs).

• NPNs are not associated with overall or PM-free survival (PMFS).

• Cervical lymph node involvement is an independent prognostic factor affecting PMFS.

• Platelet-lymphocyte ratio ≥126 is another predictor of PMFS regardless of NPN presence.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

ECOG PS:

Eastern Cooperative Oncology Group performance status

HNC:

Head and neck cancer

HNSCC:

Head and neck squamous cell carcinoma

HR:

Hazard ratio

HRCT:

High-resolution computed tomography

HU:

Hounsfield units

LN:

Lymph node

NLR:

Neutrophil-lymphocyte ratio

NPN:

Nonspecific pulmonary nodule

PET:

Positron emission tomography

PLR:

Platelet-lymphocyte ratio

PM:

Pulmonary malignancy

SPC:

Second primary cancer

Tb:

Tuberculosis

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea

    Minsu Kwon

  2. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Sang Hoon Lee, Yoon Se Lee, Jong–Lyel Roh, Seung–Ho Choi, Soon Yuhl Nam & Sang Yoon Kim

  3. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Choong Wook Lee

Authors
  1. Minsu Kwon
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  2. Sang Hoon Lee
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  3. Yoon Se Lee
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  4. Choong Wook Lee
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  5. Jong–Lyel Roh
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Corresponding author

Correspondence to Yoon Se Lee.

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Guarantor

The scientific guarantor of this publication is Yoon Se Lee.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (2016-0499).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was not required for this study because of the retrospective nature.

Methodology

• retrospective

• observational

• performed at one institution

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Kwon, M., Lee, S.H., Lee, Y.S. et al. Clinical implications of nonspecific pulmonary nodules identified during the initial evaluation of patients with head and neck squamous cell carcinoma. Eur Radiol 27, 3725–3732 (2017). https://doi.org/10.1007/s00330-017-4750-y

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  • DOI: https://doi.org/10.1007/s00330-017-4750-y

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