Differentiation of primary lung cancer from solitary lung metastasis in patients with colorectal cancer: a retrospective cohort study

• Published in: World journal of surgical oncology 2021-01, Vol.19 (1), p.28-28, Article 28
• Main Authors: Lee, Jong Eun, Jeong, Won Gi, Kim, Yun-Hyeon
• Format: Article
• Language: English
• Subjects: Aged; Agreements; Biopsy; Care and treatment; Cohort analysis; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - diagnostic imaging; Complications and side effects; Computed tomography; CT imaging; Diagnosis; Evaluation; Female; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung tumors; Male; Medical imaging; Metastases; Metastasis; Morphology; Parameter identification; Primary lung cancer; Prognosis; Regression analysis; Retrospective Studies; Solitary metastasis; Solitary pulmonary nodule; Solitary Pulmonary Nodule - diagnostic imaging; Thorax
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-021-02131-7

This study aimed to evaluate the computed tomography (CT) features of solitary pulmonary nodule (SPN), which can be a non-invasive diagnostic tool to differentiate between primary lung cancer (LC) and solitary lung metastasis (LM) in patients with colorectal cancer (CRC). This retrospective study included SPNs resected in CRC patients between January 2011 and December 2019. The diagnosis of primary LC or solitary LM was based on histopathologic report by thoracoscopic wedge resection. Chest CT images were assessed by two thoracic radiologists, and CT features were identified by consensus. Predictive parameters for the discrimination of primary LC from solitary LM were evaluated using multivariate logistic regression analysis. We analyzed CT data of 199 patients (mean age, 65.95 years; 131 men and 68 women). The clinical characteristic of SPNs suggestive of primary LC rather than solitary LM was clinical stages I-II CRC (P < 0.001, odds ratio [OR] 21.70). The CT features of SPNs indicative of primary LC rather than solitary LM were spiculated margin (quantitative) (P = 0.020, OR 8.34), sub-solid density (quantitative) (P < 0.001, OR 115.56), and presence of an air bronchogram (quantitative) (P = 0.032, OR 5.32). Quantitative CT features and clinical characteristics of SPNs in patients with CRC could help differentiate between primary LC and solitary LM.