2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.04B.05 Discordance Between Nodule and Lung Cancer Location in Early Lung Cancer Detection Cohorts.

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The study conducted by Osarenren Ogbeide, MD, analyzes the concordance between the location of lung nodules and the development of lung cancer in patients who underwent lung cancer screening (LCS) or management in a lung nodule program (LNP). This research aimed to understand how often lung cancer arises from an identified nodule or a different location. The cohort included patients diagnosed with lung cancer between 2015 and 2023, with a focus on dominant nodules—those largest by size if multiple nodules were present.<br /><br />Results revealed that cancer arose from the same location as the dominant nodule 60% of the time in the LCS cohort and 70% in the LNP cohort, indicating a significant rate of discordance where cancer developed elsewhere. Adenocarcinoma was the predominant cancer type identified, while small cell lung cancer showed more discordance. The discordant group had a notably higher proportion of patients with stage IV cancer, and treatment occurred less frequently in discordant cases. Furthermore, multiple nodules were more common in discordant cases, and the median cancer nodule size tended to exceed that of the dominant nodule, more so in discordant cases. Interestingly, cancer was mostly diagnosed in the upper lobes within concordant groups, lacking a clear pattern in discordant cases.<br /><br />The findings suggest that in a significant number of cases (25% or more), especially in high-risk individuals, the dominant nodule is not the cancer source. This highlights potential limitations of current imaging and AI technologies that primarily analyze nodule characteristics. The research stresses the need for advanced diagnostic approaches to effectively manage and monitor lung cancer risks in patients with pulmonary nodules.

Asset Subtitle

Osarenren Ogbeide

Meta Tag

Speaker Osarenren Ogbeide

Topic Screening and Early Detection

Keywords

lung cancer

lung nodules

concordance

dominant nodule

adenocarcinoma

small cell lung cancer

discordance

stage IV cancer

lung cancer screening

diagnostic approaches