2023 World Conference on Lung Cancer (Posters)-EP05.01. A Retrospective Audit of Lung Nodules with Validation of the Brock Tool in a Singaporean Cohort

EP05.01. A Retrospective Audit of Lung Nodules with Validation of the Brock Tool in a Singaporean Cohort - PDF(Abstract)

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This document presents a retrospective audit of lung nodules in a Singaporean cohort, with a focus on validating the use of the Brock tool for predicting malignancy. Lung nodule management is challenging in Asia due to the higher incidence of tuberculosis and lung cancers in never smokers, and there are currently no evidence-based Asian guidelines for their management. The Brock tool is a risk prediction algorithm that has been validated for predicting malignancy in indeterminate pulmonary nodules, but its performance in Asian populations has not been widely validated.<br /><br />The retrospective audit involved five respiratory physicians/trainees who analyzed electronic health records of 170 individuals with lung nodules. They computed Brock scores for 163 cases with single or multiple pulmonary nodules between January 2016 and December 2017. Characteristics associated with malignancy were identified, including larger nodule size, spiculation, pleural/perifissural retraction, and emphysema. No malignancy was detected in nodules smaller than 5mm, in patients younger than 50 years, or in calcified nodules.<br /><br />The computed Brock scores showed a median score of 13.5% in the lung cancer group and 1.0% in the non-lung cancer group. The area under the receiver operating curve (AUROC) for the Brock tool was 0.76, indicating moderate accuracy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Brock tool were calculated.<br /><br />The study concludes that international guidelines for pulmonary nodules are applicable in Singapore. It suggests that nodules in younger patients, size 5mm, and calcified nodules may not need follow-up. The Brock tool performed well despite some missing data and clinician-derived calculations. However, it should be noted that this study is based on a small retrospective sample, and further research is needed to validate these findings in larger Asian populations.

Asset Subtitle

Mamta Ruparel

Meta Tag

Speaker Mamta Ruparel

Topic Pulmonology & Staging

Keywords

retrospective audit

lung nodules

Singaporean cohort

Brock tool

predicting malignancy

lung nodule management

Asian guidelines

risk prediction algorithm

indeterminate pulmonary nodules

Asian populations