Maurizio Balbi, F. Sabia, R. Ledda, L. Rolli, G. Milanese, M. Ruggirello, Camilla Valsecchi, A. Marchianò, N. Sverzellati, U. Pastorino
{"title":"监测实性下结节可避免肺癌筛查中不必要的切除术:前瞻性 BioMILD 试验的长期结果","authors":"Maurizio Balbi, F. Sabia, R. Ledda, L. Rolli, G. Milanese, M. Ruggirello, Camilla Valsecchi, A. Marchianò, N. Sverzellati, U. Pastorino","doi":"10.1183/23120541.00167-2024","DOIUrl":null,"url":null,"abstract":"The management of sub-solid 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 CT 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.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 LDCT rounds. The outcomes of the study were LC detection and long-term survival.A total of 844 NSNs and 241 PSNs were included. LC detection was 3.7% (31/844) in NSNs and 7.1% (17/241) in PSNs, being significantly greater in prevalent than incident nodules (8.4%versus1.3% in NSNs; 14.1%versus2.1% in PSNs; p-value for both nodule types<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.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.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surveillance of subsolid nodules avoids unnecessary resections in lung cancer screening: Long-term results of the prospective BioMILD trial\",\"authors\":\"Maurizio Balbi, F. Sabia, R. Ledda, L. Rolli, G. Milanese, M. Ruggirello, Camilla Valsecchi, A. Marchianò, N. Sverzellati, U. Pastorino\",\"doi\":\"10.1183/23120541.00167-2024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The management of sub-solid 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 CT 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.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 LDCT rounds. The outcomes of the study were LC detection and long-term survival.A total of 844 NSNs and 241 PSNs were included. LC detection was 3.7% (31/844) in NSNs and 7.1% (17/241) in PSNs, being significantly greater in prevalent than incident nodules (8.4%versus1.3% in NSNs; 14.1%versus2.1% in PSNs; p-value for both nodule types<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.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.\",\"PeriodicalId\":11739,\"journal\":{\"name\":\"ERJ Open Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ERJ Open Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1183/23120541.00167-2024\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/23120541.00167-2024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Surveillance of subsolid nodules avoids unnecessary resections in lung cancer screening: Long-term results of the prospective BioMILD trial
The management of sub-solid 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 CT 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.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 LDCT rounds. The outcomes of the study were LC detection and long-term survival.A total of 844 NSNs and 241 PSNs were included. LC detection was 3.7% (31/844) in NSNs and 7.1% (17/241) in PSNs, being significantly greater in prevalent than incident nodules (8.4%versus1.3% in NSNs; 14.1%versus2.1% in PSNs; p-value for both nodule types<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.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.
期刊介绍:
ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.