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Table 1 Main characteristics of the studies included in the review

From: Solitary pulmonary nodule malignancy predictive models applicable to routine clinical practice: a systematic review

Authors of the models (year of publication) Location and follow-up of the study Type of study Study population Number of subjects Prevalence of malignancy (%) Prevalence of current or past smokers (%) Statistical methods Predictor variables
M. Jacob et al. (2020) [26] Portugal, NR Retrospective cohort study Patients who underwent percutaneous CT-guided transthoracic biopsy. Only cases where the biopsy target was less than 3 cm diameters in initial CT evaluation were included.
Patients with a clinical record of interstitial lung disease were excluded.
121 53% Benign nodules: 48%
Malignant nodules: 51.9%
Logistic regression analysis Clinical/radiological characteristics
Chen W et al. (2020) [22] China, NR Retrospective case–control study Patients who had undergone PN resection. The inclusion criterion was patients with PN of ≤ 10 mm in size on preoperative chest high-resolution CT.
The exclusion criteria were 10% increase in maximum diameter within 3 months; personal or family history of cancer; or lesions completely calcified.
216 74% NR Logistic regression analysis Clinical/radiological characteristics
Wu Z et al. (2020) [23] China, NR Retrospective cohort study Patients with the radiographic diagnosis of SPNs. All diagnoses of SPNs were pathologically confirmed through operation or biopsy.
Patients with multiple nodules or history of lung cancer or extrapulmonary carcinoma were excluded.
721 NR Benign nodules: 19%
Malignant nodules: 28%
Logistic regression analysis Clinical/radiological characteristics
Chen et al. (2019) [17] China, NR Retrospective cohort study Patients with SPNs who underwent surgical resection to confirm the benignity /malignancy of the nodule.
The exclusion criteria were patients with a history of cancer (≤ 5 years ago), immunocompromised patients, PN with a feeding artery and vein typical, PN with intranodular fat or calcium content or absence of the available thin-slice (1 mm) images.
493 43.4% Benign nodules: 34.05%
Malignant Nodules: 33.18%
Logistic regression analysis Clinical/radiological characteristics and serum biomarkers
Wang et al. (2018) [28] China,2 years Retrospective cohort study Patients who were confirmed with SPNs and had undergone PET/CT. Malignant nodules were confirmed by histopathologic examination of the tissue obtained by surgery or biopsy and benign nodules were confirmed by pathologic diagnosis or clinical follow-up.
Patients with the longest diameter of SPNs < 7 mm, a history of primary lung cancer, or related thoracic surgery with distant metastasis were excluded.
177 67.23% NR Logistic regression analysis Clinical/radiological characteristics
She et al. (2017) [24] China, NR Retrospective cohort study Patients with benign/malignant SPNs diagnosed by thin-section CT radiologically confirmed by surgery or biopsy.
Subsolid nodules and any indeterminate nodule were excluded.
899 67.3% 19.7% Logistic regression analysis Clinical/ radiological characteristics and serum biomarkers
Yang et al. (2017) [29] China, NR Retrospective cohort study Patients with SPNs who underwent CT-guided needle biopsy in their hospital. All of them had biopsy pathology results of benign /malignant nodule.
Patients with a history of primary lung cancer were excluded.
1078 66.88% Benign nodules: 32.4% Malignant nodules: 40%
Indeterminate nodules: 37.7%
Logistic regression analysis Clinical and radiological characteristics
Van Gómez López et al. (2015) [16] Spain, NR Retrospective cohort study Patients with a SPN who underwent a combined whole-body FDG PET/CT imaging and surgical resection of the SPN. A definitive pathologic diagnosis of the SPN, classifying the lesions as benign or malignant, was established. 55 72.7% NR Logistic regression analysis Clinical/ radiological characteristics
Zheng et al. (2015) [18] China, NR Retrospective cohort study Patients with newly discovered SPN found on conventional chest CT scans.
A definite benign/malignant diagnosis was obtained based on pathology examination.
Patients who were diagnosed as having any cancer within the previous 5 years were excluded, as were those with a history of primary lung cancer or with multiple distant metastases.
846 NR Benign nodules: 30.05%
Malignant nodules: 22.3%
Logistic regression analysis Clinical/radiological characteristics and serum biomarkers
Zhang et al. (2015) [25] China, NR Retrospective cohort study Patients who underwent surgery /lung resection for histopathological diagnosis of SPN.
An exclusion criterion was incomplete data.
294 59.9% Benign nodules: 31.4%
Malignant nodules: 48.3%
Logistic regression analysis Clinical/radiological characteristics and serum biomarkers
Dong et al. (2013) [15] China, NR Retrospective cohort study Patients with SPNs diagnosed by chest CT scans or X-ray with a histological diagnosis report as a benign or malignant nodule.
Exclusion criteria were patients had antineoplastic therapy, radiotherapy or chemotherapy prior to surgery, cancer diagnosis within one year prior to the operation for SPNs; patients had incomplete clinical data; postoperative histological diagnosis of patients was the metastatic cancer of extrapulmonary organs.
1679 77.45% 47% Logistic regression analysis Clinical/ radiological characteristics and serum biomarkers
Li et al. (2012) [19] China, NR Retrospective cohort study Patients who had a solitary pulmonary nodule resection to obtain a pathological diagnosis of benignity or malignancy.
Patients were excluded if they had a history of pulmonary or extrapulmonary malignancy in 5 years or incomplete data.
371 61.7% Benign nodules: 32.4%
Malignant nodules: 48%
Logistic regression analysis Clinical and radiological characteristics
Yonemori et al. (2007) [20] Japan, NR Retrospective cohort study Patients who underwent surgery for histopathological diagnosis of SPN.
Any SPN diagnosed as metastatic extrapulmonary cancer or any cancer within the past 5 years was excluded.
452 75% Benign nodules: 47%
Malignant nodules: 54%
Logistic regression analysis Clinical/radiological characteristics and serum biomarkers
Gould et al. (2007) [27] USA, 2 years Retrospective cohort study Patients from 10 geographically diverse VA sites with newly discovered PN seen on chest radiograph.
Exclusion criteria included age < 21 years, presence of pregnancy or lactation, weight > 350 to 400 lbs, intercurrent pulmonary infection, thoracic surgery within 6 months, radiotherapy to the chest within 1 year, and life expectancy of < 1 year.
375 54% Benign nodules: 91%
Malignant nodules: 97%
Logistic regression analysis Clinical and radiological characteristics
Swensen et al. (1997) [21] USA, 2 years Retrospective cohort study They also excluded participants who did not have a qualifying CT scan and/or did not have a definitive diagnosis of an SPN. as malignant or benign established.
Patients with newly discovered SPNs detected by chest radiograph or CT scans.
Patients who were diagnosed as having any cancer within the past 5 years were excluded. No patients with clinical signs of persistent or recurrent malignant neoplasm or with a history of primary lung cancer were included.
629 23% Benign nodules: 61%
Malignant nodules: 86%
Indeterminate nodules: 71%
Logistic regression analysis Clinical and radiological characteristics
  1. Abbreviations: SPN, solitary pulmonary nodule; PN, pulmonary nodule; VA, Veterans Affairs; cm, centimetres; PET, positron emission tomography; FDG PET/CT, F-fluorodeoxyglucose-positron emission tomography/computed tomography; NR, not reported