Indeterminate nodules in osteosarcoma: what’s the follow-up?

Abstract

Indeterminate nodules remain a clinical and diagnostic dilemma. Close monitoring of patients is advised during the first year from presentation, and there is potential for indeterminate nodules to develop into frank metastases later than five years from presentation.

Clinical significance of indeterminate pulmonary nodules on the survival of 364 patients with nonmetastatic, high‐grade, localized osteosarcoma: A 12‐year retrospective cohort study

“…Close observation of nodules and assessment of the response to chemotherapy is a useful strategy in patients who present with IPNs 19 . However, few studies have reported alterations in the radiological features of IPNs 12 . In our study, we retrospectively observed the radiological changes in IPNs and speculated the benign or malignant characteristics of these IPNs at presentation.…”

“…The effects of IPNs on survival of patients with osteosarcoma remain controversial 12,15,16 . We observed changes in radiological characteristics of IPNs and investigated the role of IPNs in pulmonary metastasis.…”

“…Some studies have discussed the clinical significance of pulmonary nodules in patients with malignancy 12,13,17 . However, the definitions of IPNs used across studies were inconsistent.…”

“…Unfortunately, percutaneous needle biopsy is not always feasible, particularly for small‐sized nodules. Uncertainty regarding the malignant potential of such nodules causes stress and affects patients' quality of life 12 …”

“…Although most IPNs are benign lesions, the risk of malignancy cannot be excluded 12,13 . Survival of patients with IPNs might be affected by undetected micro‐metastasis of certain IPNs, and these patients should receive adjustment treatment along with closer follow‐up 14 .…”