Long-term Outcomes of Patients With Ground-Glass Opacities Detected Using CT Scanning

While size matters—advanced “Radiomics” remain promising for the clinical management of ground glass opacities

“…However, several recently published prospective and large cohort studies indicate that sub-solid nodules and more specifically pGGN rarely become clinically relevant (4,8,12). Only 13% of all pGGN enlarged during follow up and 4% of ultimately surgically resected pGGN were classified as IA (4,12).…”

“…Only 13% of all pGGN enlarged during follow up and 4% of ultimately surgically resected pGGN were classified as IA (4,12). The single patient presenting with a pGGN who eventually developed recurrent lung cancer had a large (27 mm) lesion at the time of diagnosis (4,12).…”

“…Among all the surgically resected sub-solid nodules all but one cancer represented stage 1A disease, and during 10-year post-resection follow-up only 1.6% (2 cases) recurred (4,12). Most aggressive lesions appear to be characterized by a significant solid component of >2 mm raising the question whether currently recommended management strategies are prematurely triggering surgical interventions in response to a >2 mm size increase of pGGN in the absence of the development of a solid component is resulting in overtreatment (4,8,12). In the opinion of experts and in our own clinical practice surgical interventions, biopsy or SBRT are typically triggered by the emergence of a significant (>2 mm) solid component rather than a simple increase in the size of the ground glass component of the pGGN (4).…”

“…The single patient presenting with a pGGN who eventually developed recurrent lung cancer had a large (27 mm) lesion at the time of diagnosis (4,12). Among all the surgically resected sub-solid nodules all but one cancer represented stage 1A disease, and during 10-year post-resection follow-up only 1.6% (2 cases) recurred (4,12). Most aggressive lesions appear to be characterized by a significant solid component of >2 mm raising the question whether currently recommended management strategies are prematurely triggering surgical interventions in response to a >2 mm size increase of pGGN in the absence of the development of a solid component is resulting in overtreatment (4,8,12).…”

“…Only 13% of all pGGN enlarged during follow up and 4% of ultimately surgically resected pGGN were classified as IA (4,12). The single patient presenting with a pGGN who eventually developed recurrent lung cancer had a large (27 mm) lesion at the time of diagnosis (4,12). Among all the surgically resected sub-solid nodules all but one cancer represented stage 1A disease, and during 10-year post-resection follow-up only 1.6% (2 cases) recurred (4,12).…”