Surveillance of subsolid nodules avoids unnecessary resections in lung cancer screening: long-term results of the prospective BioMILD trial.

Autor:	Balbi M; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.; Radiology Unit, San Luigi Gonzaga Hospital, Department of Oncology, University of Turin, Orbassano, Italy., Sabia F; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Ledda RE; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.; Section of Radiology, Department of Medicine and Surgery (DiMeC), University Hospital of Parma, Parma, Italy., Rolli L; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Milanese G; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.; Section of Radiology, Department of Medicine and Surgery (DiMeC), University Hospital of Parma, Parma, Italy., Ruggirello M; Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Valsecchi C; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Marchianò A; Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Sverzellati N; Section of Radiology, Department of Medicine and Surgery (DiMeC), University Hospital of Parma, Parma, Italy., Pastorino U; Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2024 Aug 27; Vol. 10 (4). Date of Electronic Publication: 2024 Aug 27 (Print Publication: 2024).
DOI:	10.1183/23120541.00167-2024
Abstrakt:	Background: The management of subsolid nodules (SSNs) in lung cancer screening (LCS) is still a topic of debate, with no current uniform strategy to deal with these lesions at risk of overdiagnosis and overtreatment. The BioMILD LCS trial has implemented a prospective conservative approach for SSNs, managing with annual low-dose computed tomography nonsolid nodules (NSNs) and part-solid nodules (PSNs) with a solid component <5 mm, regardless of the size of the nonsolid component. The present study aims to determine the lung cancer (LC) detection and survival in BioMILD volunteers with SSNs. Materials and Methods: Eligible participants were 758 out of 4071 (18.6%) BioMILD volunteers without baseline LC and at least one SSN detected at the baseline or further low-dose computed tomography rounds. The outcomes of the study were LC detection and long-term survival. Results: A total of 844 NSNs and 241 PSNs were included. LC detection was 3.7% (31 out of 844) in NSNs and 7.1% (17 out of 241) in PSNs, being significantly greater in prevalent than incident nodules (8.4% versus 1.3% in NSNs; 14.1% versus 2.1% in PSNs; p-value for both nodule types p<0.01). Most LCs from SSNs were stage I (42/48, 87.5%), resectable (47/48, 97.9%), and caused no deaths. The 8-year cumulative survival of volunteers with LC derived from SSNs and not derived from SSNs was 93.8% and 74.9%, respectively. Conclusion: Conservative management of SSNs in LCS enables timely diagnosis and treatment of LCs arising from SSNs while ensuring the resection of more aggressive LCs detected away from SSNs. Competing Interests: Conflict of interest: R.E. Ledda reports consulting fees from Brainomix Limited and lecture honoraria from Boehringer Ingelheim outside the submitted work. Conflict of interest: N. Sverzellati reports consulting fees from Chiesi, AstraZeneca and Coreline; lecture honoraria from Boehringer Ingelheim, Chiesi and AstraZeneca; travel support from Bracco; and advisory board participation from AstraZeneca and Boehringer Ingelheim, all outside the submitted work. Conflict of interest: All other authors have nothing to disclose. (Copyright ©The authors 2024.)
Databáze:	MEDLINE
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