Malignant pure pulmonary ground-glass opacity nodules: prognostic implications

Area of Science:

• Pulmonology
• Thoracic Surgery
• Oncology

Background:

• Malignant pulmonary nodules, particularly those appearing as pure ground-glass opacity (GGO) on high-resolution CT (HRCT), require careful evaluation for optimal patient management.
• Understanding the long-term prognosis of these lesions is crucial for guiding treatment decisions and patient follow-up strategies.

Purpose of the Study:

• To evaluate the follow-up outcomes and patient prognosis for malignant pulmonary nodules presenting as pure GGO lesions on HRCT.
• To determine if factors such as nodule characteristics, surgical approach, or pre-operative changes influence patient prognosis.

Main Methods:

• Surgical resection was performed on 58 patients with malignant GGO nodules.
• Patient prognosis was assessed based on clinical status and HRCT findings post-surgery.
• Statistical analysis, including Fisher's exact test and Pearson's chi-squared test, compared prognoses relative to nodule number, size, surgical method, size changes, and histopathology.

Main Results:

• Of 58 patients, 40 had bronchioloalveolar carcinoma (BAC) and 18 had adenocarcinoma with a predominant BAC component.
• No local recurrence or metastasis was observed in any patient within a 24-month follow-up period (range: 12-65 months).
• In patients with multiple GGO nodules, resection led to no recurrence; remaining nodules showed stability or decrease in size.

Conclusions:

• Patients with pure GGO malignant pulmonary nodules exhibit excellent prognoses following surgical intervention.
• Prognosis is not significantly affected by nodule number, size, surgical method, pre-operative size changes, or histopathological diagnosis.