Should indeterminate lung lesions reported on staging CT scans influence the management of patients with colorectal cancer?

OBJECTIVE: The aim of this study was to determine the significance of indeterminate lung lesions reported from staging CT scans on patients with colorectal cancer. METHOD: CT-scan reports of 439 patients were reviewed to identify patients in which indeterminate lung lesion had been reported. The tumour, node, metastasis (TNM) stage of these patients was recorded together with any follow-up scan reports or multidisciplinary team (MDT) discussions regarding these lesions.

RESULTS: Twenty-three patients had definite lung metastases. Forty-five patients had indeterminate lung lesions. Of these, 22 patients had N1 or N2 disease, 20 had N0 disease and three patients were not operated on due to comorbidity.

Of these 45 patients, 30 had further follow-up scans. In 19, the indeterminate lesions were unchanged and were therefore downgraded to benign lesions. The lesions had progressed or new lesions had developed in five.

These patients were therefore shown to have metastatic lung disease. All ... more.

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