Management and Outcomes of Pulmonary Nodules in a Real-World Setting
<b>Background and Objective:</b> Due to the increasing use of imaging and lung cancer screening programs, the rate of detected pulmonary nodules has steadily increased over the past decade. Overall, the diagnosis and management of pulmonary nodules remain challenging. Moreover, no specif...
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MDPI AG
2025-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/13/1677 |
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| author | Berta Mosleh Pavla Sarova Helmut Prosch Joachim Widder Clemens Aigner Marco Idzko Mir Alireza Hoda Daniela Gompelmann |
| author_facet | Berta Mosleh Pavla Sarova Helmut Prosch Joachim Widder Clemens Aigner Marco Idzko Mir Alireza Hoda Daniela Gompelmann |
| author_sort | Berta Mosleh |
| collection | DOAJ |
| description | <b>Background and Objective:</b> Due to the increasing use of imaging and lung cancer screening programs, the rate of detected pulmonary nodules has steadily increased over the past decade. Overall, the diagnosis and management of pulmonary nodules remain challenging. Moreover, no specific guidelines exist for the management of pulmonary nodules in patients with a history of previous malignancy. This study reflects the current management in a real-world setting in a specialized European center. <b>Methods:</b> In this retrospective single-center study, patients with a pulmonary nodule <3 cm referred to the Division of Pulmonology or the Department of Thoracic Surgery at the Medical University of Vienna, Austria, from November 2022 to July 2024, were analyzed. A subgroup analysis of patients with a history of previous malignancy was performed and compared to patients without previous malignancies. <b>Results:</b> In total, 356 patients (48.5% male, median age 67 years [IQR 61–74], 53.7% with a history of previous cancer) with a pulmonary nodule (mean size of 14.8 mm) were enrolled. Bronchoscopy, computed tomography (CT)-guided biopsy, or surgery was performed in 13.2%, 7.3%, and 65.2% of the cases, respectively. The overall malignancy rate was 70.5%. Pulmonary nodules in patients with a prior malignancy were significantly larger (<i>p</i> < 0.001), showed a progression in size (<i>p</i> < 0.001), and were found to be malignant more frequently when compared to patients without previous cancer (<i>p</i> = 0.032). <b>Conclusions:</b> As most patients referred to a specialized center represent a selected group of high-risk patients, the majority of pulmonary nodules were found to be malignant. In patients with a history of previous malignancy, tissue sampling is warranted as the rate of malignancy is high. |
| format | Article |
| id | doaj-art-0103aa289d504dd297fecd14cb258651 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-0103aa289d504dd297fecd14cb2586512025-08-20T03:50:17ZengMDPI AGDiagnostics2075-44182025-07-011513167710.3390/diagnostics15131677Management and Outcomes of Pulmonary Nodules in a Real-World SettingBerta Mosleh0Pavla Sarova1Helmut Prosch2Joachim Widder3Clemens Aigner4Marco Idzko5Mir Alireza Hoda6Daniela Gompelmann7Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, AustriaDivision of Pulmonology, Department of Internal Medicine II, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Biomedical Imaging and Image-Guided Therapy, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Radiation Oncology, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University Vienna, 1090 Vienna, AustriaDepartment of Thoracic Surgery, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, AustriaDivision of Pulmonology, Department of Internal Medicine II, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Thoracic Surgery, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, AustriaDivision of Pulmonology, Department of Internal Medicine II, Comprehensive Cancer Center Vienna, Comprehensive Center for Chest Diseases, Medical University of Vienna, 1090 Vienna, Austria<b>Background and Objective:</b> Due to the increasing use of imaging and lung cancer screening programs, the rate of detected pulmonary nodules has steadily increased over the past decade. Overall, the diagnosis and management of pulmonary nodules remain challenging. Moreover, no specific guidelines exist for the management of pulmonary nodules in patients with a history of previous malignancy. This study reflects the current management in a real-world setting in a specialized European center. <b>Methods:</b> In this retrospective single-center study, patients with a pulmonary nodule <3 cm referred to the Division of Pulmonology or the Department of Thoracic Surgery at the Medical University of Vienna, Austria, from November 2022 to July 2024, were analyzed. A subgroup analysis of patients with a history of previous malignancy was performed and compared to patients without previous malignancies. <b>Results:</b> In total, 356 patients (48.5% male, median age 67 years [IQR 61–74], 53.7% with a history of previous cancer) with a pulmonary nodule (mean size of 14.8 mm) were enrolled. Bronchoscopy, computed tomography (CT)-guided biopsy, or surgery was performed in 13.2%, 7.3%, and 65.2% of the cases, respectively. The overall malignancy rate was 70.5%. Pulmonary nodules in patients with a prior malignancy were significantly larger (<i>p</i> < 0.001), showed a progression in size (<i>p</i> < 0.001), and were found to be malignant more frequently when compared to patients without previous cancer (<i>p</i> = 0.032). <b>Conclusions:</b> As most patients referred to a specialized center represent a selected group of high-risk patients, the majority of pulmonary nodules were found to be malignant. In patients with a history of previous malignancy, tissue sampling is warranted as the rate of malignancy is high.https://www.mdpi.com/2075-4418/15/13/1677pulmonary nodulepulmonary nodule managementhigh-risk pulmonary nodulelung cancerpulmonary metastases |
| spellingShingle | Berta Mosleh Pavla Sarova Helmut Prosch Joachim Widder Clemens Aigner Marco Idzko Mir Alireza Hoda Daniela Gompelmann Management and Outcomes of Pulmonary Nodules in a Real-World Setting Diagnostics pulmonary nodule pulmonary nodule management high-risk pulmonary nodule lung cancer pulmonary metastases |
| title | Management and Outcomes of Pulmonary Nodules in a Real-World Setting |
| title_full | Management and Outcomes of Pulmonary Nodules in a Real-World Setting |
| title_fullStr | Management and Outcomes of Pulmonary Nodules in a Real-World Setting |
| title_full_unstemmed | Management and Outcomes of Pulmonary Nodules in a Real-World Setting |
| title_short | Management and Outcomes of Pulmonary Nodules in a Real-World Setting |
| title_sort | management and outcomes of pulmonary nodules in a real world setting |
| topic | pulmonary nodule pulmonary nodule management high-risk pulmonary nodule lung cancer pulmonary metastases |
| url | https://www.mdpi.com/2075-4418/15/13/1677 |
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