UNASSIGNED: 377 Background: Many @entity1 with newly diagnosed @entity1358 ( @entity1358 ) are found to have indeterminate lung nodules at the time of diagnosis. Current guidelines are vague about the necessity and frequency of additional chest imaging. We sought to determine whether the presence of indeterminate lung nodules at the time of diagnosis affects long-term survival for @entity1 with early stage @entity1358 . METHODS: A retrospective review was performed of all @entity1 at our institution who underwent nephrectomy for stage I-III @entity1358 between 2001 and 2006 and had baseline chest imaging available for review. Presence of indeterminate lung nodule(s) on preoperative chest imaging was determined, along with @entity5 stage, grade, and histology; @entity1 age, gender, body mass index, and smoking status; and Charlson comorbidity score. The time from diagnosis to last documented follow-up, and to first detected @entity3 and/or death if applicable, was determined. Univariate and multivariate analyses were performed. The primary outcome of interest was disease-free survival; the secondary outcome was overall survival. The study follow-up period extended to July 2012. RESULTS: In a multivariate analysis of 240 @entity1 , disease-free survival was significantly associated with the presence of indeterminate lung nodules (HR 1.900, 95% CI: [1.042, 3.463]; p = 0.036). The number and size of the nodules did not add statistical significance. Disease-free survival was also associated with @entity5 stage (stage II: HR 5.611, p < 0.001; stage III: HR 2.488, p = 0.0129) and grade (HR 2.433 for grade 3 or 4, p = 0.005). Overall survival was only associated with Charlson comorbidity score (HR 1.294, p < 0.0001) and @entity5 size (HR 1.287, p < 0.0001). CONCLUSIONS: The presence of indeterminate lung nodules at the time of diagnosis of @entity1358 had a negative impact on disease-specific survival. @entity5 stage and grade were also significant prognostic factors. These findings underscore the importance of baseline chest imaging as well as vigilant surveillance of @entity1 in whom lung nodules are identified.

Prognostic significance of indeterminate lung nodules in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1358 :: ('MESH:D002292', 'Disease') :: ['renal cell carcinoma', 'RCC'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumor', 'primary tumor'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity1358 :: (MESH:D002292,Disease) :: ['renal cell carcinoma']
