BACKGROUND: To evaluate the effect of first-time and eventual reiterative surgery on overall survival (OS) and disease-free survival (DFS) in Caucasian patients affected by an invasive adenocarcinoma (ADC) with at least another ground-glass opacity (GGO). METHODS: We analysed 47 patients operated on for lung ADC, identified as main cancer (MC), with at least one synchronous GGO, from January 2003 to March 2017. Characteristics associated with the evolution of GGOs were investigated with logistic regression and overall and DFS were evaluated with Kaplan-Meier method. RESULTS: Forty-two (89%) patients received an anatomic resection of the MC, 5 patients were treated by a single or multiple wedge resections. In total, 9 (19.1%) patients had all the lesions resected undergoing simultaneous resection of ipsilateral GGOs at first surgery while the remaining 38 (80.9%) patients still had at least one GGO that was followed up by serial CT scan. At the median follow-up of 41 months, GGO evolved in 16 (42.1%) patients. The presence of solid component at the initial CT scan was the only risk factor for evolution of the GGO. Thirteen patients underwent surgical resection showing an invasive ADC in 9 patients, MIA in 3 and AIS in 1. New GGOs developed in 7 (14.9%) patients, in which three underwent surgery showing the presence of solid ADC, MIA and AAH. OS rate at 5 years was 97.4%. DFS at 3 years was 82% and was significantly influenced by the stage of MC. CONCLUSIONS: Patients affected by an invasive ADC with at least another GGO nodule enjoy good OS and DFS with a surgical reiterative approach. Part-solid GGO is associated with GGO progression requiring treatment, but OS is not influenced by the new onset or evolution of GGOs. DFS is affected by the stage of the MC which dictates the treatment strategy.
BACKGROUND: To evaluate the effect of first-time and eventual reiterative surgery on overall survival (OS) and disease-free survival (DFS) in Caucasian patients affected by an invasive adenocarcinoma (ADC) with at least another ground-glass opacity (GGO). METHODS: We analysed 47 patients operated on for lung ADC, identified as main cancer (MC), with at least one synchronous GGO, from January 2003 to March 2017. Characteristics associated with the evolution of GGOs were investigated with logistic regression and overall and DFS were evaluated with Kaplan-Meier method. RESULTS: Forty-two (89%) patients received an anatomic resection of the MC, 5 patients were treated by a single or multiple wedge resections. In total, 9 (19.1%) patients had all the lesions resected undergoing simultaneous resection of ipsilateral GGOs at first surgery while the remaining 38 (80.9%) patients still had at least one GGO that was followed up by serial CT scan. At the median follow-up of 41 months, GGO evolved in 16 (42.1%) patients. The presence of solid component at the initial CT scan was the only risk factor for evolution of the GGO. Thirteen patients underwent surgical resection showing an invasive ADC in 9 patients, MIA in 3 and AIS in 1. New GGOs developed in 7 (14.9%) patients, in which three underwent surgery showing the presence of solid ADC, MIA and AAH. OS rate at 5 years was 97.4%. DFS at 3 years was 82% and was significantly influenced by the stage of MC. CONCLUSIONS: Patients affected by an invasive ADC with at least another GGO nodule enjoy good OS and DFS with a surgical reiterative approach. Part-solid GGO is associated with GGO progression requiring treatment, but OS is not influenced by the new onset or evolution of GGOs. DFS is affected by the stage of the MC which dictates the treatment strategy.
Authors: Hye-Seon Kim; Hyun-Ju Lee; Jae Hyun Jeon; Yong Won Seong; In Kyu Park; Chang Hyun Kang; Ki-Bong Kim; Jin Mo Goo; Young Tae Kim Journal: Ann Thorac Surg Date: 2013-09-29 Impact factor: 4.330
Authors: Daniel M Libby; James P Smith; Nasser K Altorki; Mark W Pasmantier; David Yankelevitz; Claudia I Henschke Journal: Chest Date: 2004-04 Impact factor: 9.410
Authors: Hong Kwan Kim; Yong Soo Choi; Kwhanmien Kim; Young Mog Shim; Sun Young Jeong; Kyung Soo Lee; O Jung Kwon; Jhingook Kim Journal: J Thorac Oncol Date: 2009-10 Impact factor: 15.609