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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Main Authors: Berta Mosleh, Pavla Sarova, Helmut Prosch, Joachim Widder, Clemens Aigner, Marco Idzko, Mir Alireza Hoda, Daniela Gompelmann
Format: Article
Language:English
Published: MDPI AG 2025-07-01
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.
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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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