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Chest CT recommended in high-risk patients with head and neck squamous cell carcinoma
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Chest CT scans may play an important role in detecting disease progression in the lungs of high-risk patients with head and neck squamous cell carcinoma, according to recent study findings.
To determine the predictive features and optimal timing for positive chest CT in patients with head and neck squamous cell carcinoma, researchers from Taipai Veterans General Hospital and other sites in Taiwan conducted a retrospective analysis.
They reviewed 270 screening chest CT scans performed in 192 patients during a 42-month period. Researchers categorized the scans as new cases, follow-up cases or recurrent cases, and classified the results as normal or abnormal.
Seventy-nine cases were abnormal (29.3%) or having a radiologic diagnosis of malignant neoplasm of the lung or an indeterminate lesion. A higher number of follow-up cases had abnormal results (44.2%) compared with new cases (14.2%; P<.001).
Patients’ diagnoses changed to malignant neoplasm of the lung when subsequent follow-up scans revealed disease progression for 10 of 15 indeterminate scans with small solitary pulmonary nodules (<1 cm). Initial N2 or N3 disease, stage IV disease, recurrent disease or distant metastases to another site were predictive factors of a malignant neoplasm of the lung, according to the researchers.
“Intensified evaluation and management are mandatory for indeterminate small solitary pulmonary nodules because of the high rate of malignant neoplasms,” the researchers wrote.
Arch Otolaryngol Head Neck Surg. 2008;134:1050-1054.