Chest
Clinical InvestigationsSurgeryRelationship Between a History of Antecedent Cancer and the Probability of Malignancy for a Solitary Pulmonary Nodule
Section snippets
PATIENTS AND METHODS
The base population for this study was composed of 1,112 patients who underwent resection of an SPN at Brigham and Women's Hospital between August 1989 and October 1998. Patients without a complete clinical history (six patients) or who had previously undergone resection of pulmonary metastases (two patients) were excluded. Therefore, 1,104 patients with an SPN undergoing an initial excisional biopsy were included in the analysis.
Preoperative information was collected prospectively for each
RESULTS
One thousand one hundred four patients (women, 55%; men, 45%; median age, 64 years; age range, 17 to 88 years) were included in the study. The cohort was composed of 767 patients (69%) without a history of cancer, 49 patients (4%) with previous lung cancer; and 288 patients (26%) with a history of extrapulmonary malignancies. Of the 49 patients with a history of lung cancer, 13 also had a history of extrapulmonary neoplasms.
DISCUSSION
An SPN in this highly selected cohort was found to be from a malignant cause in at least 63% of cases, even with no history of cancer. A history of extrapulmonary neoplasms increased the overall risk of cancer in an SPN from 63 to 79%. Primary lung cancer remained the most important cause of malignancy (52%) in this subgroup of patients, although there was roughly an even chance that a malignant nodule within this group represented a metastasis (48%). Nodules were also malignant in 82% of
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Tobacco Smoking and Risk of Second Primary Lung Cancer
2021, Journal of Thoracic OncologyCitation Excerpt :Thus, although there is a biological rationale for tobacco smoke carcinogens inducing SPLC oncogenesis through similar DNA-damaging mechanisms as with IPLC,34 it seems that the effect of tobacco smoking, while present, is modulated somewhat with SPLC. BMI, personal history of cancer, and family history of lung cancer—while protective or risk factors for IPLC35-38—had negligible associations with SPLC, as did demographics including sex, race/ethnicity, and education. This study confirmed IPLC age at diagnosis, histology, and stage as relevant predictors of SPLC, which were previously identified in a large, population-based cohort.13
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Dr. Mery was partly supported by scholarships from the Mexican Council for Science and Technology (CONACyT) and the Fundación México en Harvard, AC.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (e-mail: [email protected]).