Indeterminate pulmonary nodules in non-rhabdomyosarcoma soft tissue sarcoma: A study of the European paediatric Soft Tissue Sarcoma Study Group

Chiara Giraudo, Reineke Schoot, Liesbeth Cardoen, Roberto Stramare, Beatrice Coppadoro, Gianni Bisogno, Amine Bouhamama, Bernadette Brennan, Herve J. Brisse, Daniel Orbach, Ana Coma, Pier Luigi Di Paolo, Cindy Fayard, Leigh McDonald, Salma Moalla, Carlo Morosi, Erika Pace, Vivian Tang, Max M. van Noesel, Andrea FerrariRick van Rijn

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this study was to assess the clinical impact of indeterminate pulmonary nodules (no more than four pulmonary nodules of less than 5 mm or one nodule measuring between 5 and less than 10 mm by computed tomography [CT]) in children and adolescents with adult-type non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) at diagnosis. Methods: Patients with NRSTS treated in 11 centers as part of the European paediatric Soft Tissue Sarcoma Study Group (EpSSG) were retrospectively assessed. Local radiologists, blinded to clinical information except for patients’ age and tumor histotype, reviewed the chest CT at diagnosis and filled out a case report form. Because patients with or without indeterminate nodules in the EpSSG NRSTS 2005 study received the same type of treatment, event-free survival (EFS) and overall survival (OS) between groups by log-rank test were compared. Results: Overall, 206 patients were examined: 109 (52.9%) were without any nodules, 78 (38%) had at least one indeterminate nodule, and 19 (9.2%) had nodules meeting the definition of metastases, which were then considered to be misclassified and were excluded from further analyses. Five-year EFS was 78.5% (95% CI, 69.4%–85.1%) for patients without nodules and 69.6% (95% CI, 57.9%–78.7%) for patients with indeterminate nodules (p =.135); 5-year OS was 87.4% (95% CI, 79.3%–92.5%) and 79.0% (95% CI, 67.5%–86.8%), respectively (p =.086). Conclusions: This study suggests that survival does not differ in otherwise nonmetastatic patients with indeterminate pulmonary nodules compared to nonmetastatic patients without pulmonary nodules. Plain Language Summary: Radiologists should be aware of the classification of indeterminate pulmonary nodules in non-rhabdomyosarcoma soft tissue sarcomas and use it in their reports. More than a third of patients with non-rhabdomyosarcoma soft tissue sarcoma can be affected by indeterminate pulmonary nodules. Indeterminate pulmonary nodules do not significantly affect the overall survival of pediatric patients with non-rhabdomyosarcoma soft tissue sarcoma.
Original languageEnglish
Pages (from-to)597-608
Number of pages12
JournalCancer
Volume130
Issue number4
DOIs
Publication statusPublished - 15 Feb 2024

Keywords

  • Adolescent
  • Adult
  • Child
  • Humans
  • Progression-Free Survival
  • Retrospective Studies
  • Rhabdomyosarcoma/therapy
  • Sarcoma/drug therapy
  • Soft Tissue Neoplasms/pathology

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