Outcomes of multidisciplinary management of pulmonary nodules in a tertiary center

Abstract

Objective: A multidisciplinary approach is recommended for managing pulmonary nodules. This study aimed to examine the malignancy rates, malignancy determinants, and follow-up results of patients with pulmonary nodules whom the multidisciplinary team evaluates.

Methods: Clinical characteristics of the patients, radiological and histological characteristics of the nodules, and the follow-up outcomes were documented retrospectively. A total of 94 patients with solitary pulmonary nodules (SPNs) (n=58) and multiple pulmonary nodules (MPNs) (n=36) were included in the study.

Results: Our study showed that malignancy risk increased with irregular nodule margins (p < 0.008). Patients who had tissue sampling from suspected nodules exhibited markedly higher rates of previous malignancy than those who did not (58.5% vs. 19.5% p<0.001). For the patients with solitary pulmonary nodule (SPN), the group for whom biopsy was planned had more underlying malignancy (p=0.011) and had a bigger nodule size of 10 mm (range, 8.0-13.25 mm) vs 15.00 mm (range, 10.0-19.75 mm) (p=0.003). Among the patients who have multiple pulmonary nodules (MPN), eighty-four percent of patients in the biopsy group had underlying malignancy diagnoses, whereas this rate was 26% in the CT follow-up group (p=0.002). Adenocarcinoma was the most common SPN histology and squamous cell carcinoma for MPNs. The Multidisciplinary Thoracic Oncology Board identified malignancy in 60% of patients with SPNs and 92.3% of those with MPNs/

Conclusions: Patients evaluated in the multidisciplinary tumor board consist of a very diverse patient group. Discerning between malignant and benign conditions relies heavily on examining nodule features and assessing malignancy history.