The prognosis of invasive adenocarcinoma presenting as ground-glass opacity on chest computed tomography after sublobar resection

Abstract

Background: Ground-glass opacity (GGO) on chest computed tomography (CT) is generally associated with non-invasive or minimally invasive adenocarcinoma (MIA). However, many instances of GGO are diagnosed as invasive adenocarcinoma. The purpose of this study is to analyse the histopathologic characteristics of invasive adenocarcinoma presenting as GGO and the prognosis after sublobar resection. Methods: We conducted a retrospective chart review of 191 patients who were treated for stage I nonsmall cell lung cancer presenting as a GGO-predominant tumour upon CT and who underwent curative resection. We analysed the histologic subtypes and components of invasive adenocarcinomas presenting as GGO-predominant tumours. We also compared the 5-year recurrence-free survival (RFS) of invasive adenocarcinomas presenting as GGO-predominant in patients undergoing sublobar resection or lobectomy. Results: Of 191 GGO-predominant tumour patients, 97 patients had adenocarcinoma in situ (AIS) or MIA, and 94 patients had invasive adenocarcinoma. In the analysis of the histologic component of invasive adenocarcinoma presenting as GGO, the mean rate of the lepidic component was 47.4%, that of the acinar component was 42.1%, and that of the papillary component was 7.3%. Micropapillary and solid components were nearly absent. The 5-year RFS rates of sublobar resection and lobectomy were both 100%. Conclusions: Invasive components such as acinar and papillary components can also be seen as GGO tumours on chest CT. After the sublobar resection of GGO-predominant tumours, a good prognosis can be expected, even if the tumour is an invasive adenocarcinoma such as the acinar or papillary subtypes.

Clinical characteristics and prognosis of ground-glass opacity nodules in young patients

“…There were no significant differences between subarachnoidectomy and lobectomy in survival rates (23,28). Moon thought lobectomy may not be the best treatment option, limited removal of all GGO cases may be a reasonable choice regardless of the histological morphology of early adenocarcinoma (29,30). Although the arguments were different, it was undeniable that the advantage of segmentectomy was that the nodules can be removed while retaining normal lung tissue maximally.…”

3D convolutional neural network for differentiating pre-invasive lesions from invasive adenocarcinomas appearing as ground-glass nodules with diameters ≤3 cm using HRCT

“…The new classification had an important effect on the choice of treatment and follow-up of patients because the prognosis of different pathological subtypes varies greatly. Studies have shown that diseasefree survival in early stage AIS and MIA patients is close to 100% (4,5), while disease-free survival in IACs patients is 60-70% (6)(7)(8). Therefore, it is very important to accurately evaluate the risk of malignant lesions on diagnostic CT for early intervention.…”

Novel Asymmetrical Linear Stapler (NALS) for pathologic evaluation of true resection margin tissue

“…With the development of chest CT, the diagnosis of early NSCLC has improved, which has resulted in an increase in limited resection in patients who can tolerate a lobectomy. The oncological outcomes in recent studies support this trend (18)(19)(20). Hence, we are concerned with the failure to obtain an R0 resection with a limited lung resection in early lung cancer.…”