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Significance of pulmonary nodules in patients with colorectal cancer

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Radiographically small pulmonary nodules (PNs) in patients with colorectal cancer are troublesome because their discovery raises concern about metastases. This study sought to establish the appropriate timing of radiological follow-up for PNs detected at initial staging evaluation of colorectal carcinoma patients.

Methods

The medical records of 376 consecutive colorectal cancer patients who underwent curative surgery and had baseline and follow-up chest X-rays (CXR) and computed tomography (CT) were reviewed.

Results

The study included 92 patients who had all CXR and chest CT available for review, at least one PN found on baseline imaging, and no synchronous neoplasms. On baseline chest CT, these 92 patients had 170 PNs altogether and 77 (45.2 %) of them were greater than 5 mm in size. Baseline CXR detected 13 PNs in 12 patients and all but 2 were larger than 5 mm. Nodule size greater than 5 mm and irregular margins were predictors of nodule growth. The mean doubling time of 24/170 (14.1 %) growing PNs was about 4 months.

Conclusions

Our findings suggest that baseline and follow-up CXR are pointless, and short-interval CT follow-up is warranted when PNs larger than 5 mm with irregular margins are detected on preoperative chest CT.

Key Points

• Pulmonary nodules in colorectal cancer patients raise concern about metastasis.

• Baseline and follow-up chest X-ray in colorectal cancer can be abandoned.

• CT is the best technique for assessing PNs in colorectal cancer.

• Short-interval CT follow-up advisable for PNs larger than 5 mm with irregular margins.

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Authors and Affiliations

  1. Oncological Radiology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

    Fabio Pomerri, Ernesta Perrone & Giovanna Pintacuda

  2. Department of Medicine, University of Padua, Padua, Italy

    Fabio Pomerri

  3. Department of Oncological and Surgical Sciences, 2nd Surgical Clinic, University of Padua, Padua, Italy

    Salvatore Pucciarelli & Donato Nitti

  4. Surgical Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

    Isacco Maretto

  5. Medical Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

    Sara Lonardi

  6. Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

    Pier Carlo Muzzio

  7. Istituto Oncologico Veneto IOV-IRCCS, Radiologia, via Gattamelata 64, 35128, Padova, Italy

    Fabio Pomerri

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  1. Fabio Pomerri
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  2. Salvatore Pucciarelli
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  3. Isacco Maretto
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  4. Ernesta Perrone
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Correspondence to Fabio Pomerri.

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Pomerri, F., Pucciarelli, S., Maretto, I. et al. Significance of pulmonary nodules in patients with colorectal cancer. Eur Radiol 22, 1680–1686 (2012). https://doi.org/10.1007/s00330-012-2431-4

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  • DOI: https://doi.org/10.1007/s00330-012-2431-4

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