Malignant Pure Pulmonary Ground-Glass Opacity Nodules: Prognostic Implications

Abstract

ObjectiveThis study was designed to evaluate follow-up results in terms of patient prognosis for malignant pulmonary nodules depicted as pure ground-glass opacity (GGO) lesion observed at high-resolution CT (HRCT).Materials and MethodsSurgical removal for malignant GGO nodules was accomplished in 58 patients (26 men, 32 women; mean age, 57 years; age range, 29-78 years). Patient prognoses were assessed by patient clinical status and the presence of changes in nodule size determined after a follow-up HRCT examination. Differences in patient prognoses were compared for nodule number, size, surgical method, change in size before surgical removal, and histopathological diagnosis by use of Fisher's exact test and Pearson's chi-squared test.ResultsOf the 58 patients, 40 patients (69%) were confirmed to have a bronchioloalveolar carcinoma (BAC) and 18 patients (31%) were confirmed to have an adenocarcinoma with a predominant BAC component. Irrespective of nodule size, number, treatment method, change in size before surgical removal and histopathological diagnosis, neither local recurrence nor a metastasis occurred in any of these patients as determined at a follow-up period of 24 months (range; 12-65 months). Of 14 patients with multiple GGO nodules, all of the nodules were resected without recurrence in six patients. In the remaining eight patients, the remaining nodules showed no change in size in seven cases and a decrease in size in one case as determined after a follow-up CT examination.ConclusionPrognoses in patients with pure GGO malignant pulmonary nodules are excellent, and not significantly different in terms of nodule number, size, surgical method, presence of size change before surgical removal and histopathological diagnosis.

The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Application of TNM Staging Rules to Lung Cancer Presenting as Multiple Nodules with Ground Glass or Lepidic Features or a Pneumonic Type of Involvement in the Forthcoming Eighth Edition of the TNM Classification

“…12,[23][24][25][26][27][28][29] This observation is made in both Asian and North American populations. The proportion of nonsmokers (30-80%) varies with the regional prevalence of smoking but is always greater than that of the general prevalence in patients with lung cancer in that region.…”

Surgical outcomes in lung cancer presenting as ground-glass opacities of 3 cm or less: A review of 5 years' experience

“…Park et al 22 reported an excellent prognosis in a cohort of 58 patients with malignant pure GGOs who underwent surgical resection. There was no incidence of local recurrence or metastasis occurring in any of these patients after 24 months of follow up.…”

Meta-analysis of CT-guided transthoracic needle biopsy for the evaluation of the ground-glass opacity pulmonary lesions

“…19 However, malignant GGO lesions can remain stable in size for as long as 36 months. 20 In addition, during the observation period, some malignant tumours will progress from being resectable to unresectable. 21 GGO lesions have been reported to have a good prognosis, and, in most cases, their pathological features are minimally invasive.…”