Partly solid pulmonary nodules: waiting for change or surgery outright?

Area of Science:

• Thoracic surgery
• Pulmonary medicine
• Oncology

Background:

• Partly solid lung tumours require careful management decisions regarding surgical timing.
• Preoperative changes in solid components may influence prognosis and surgical strategy.
• Distinguishing between stable and changing lesions is crucial for patient care.

Purpose of the Study:

• To compare pathological findings and prognosis between patients with partly solid lung tumours showing changes versus no changes in the solid component during follow-up.
• To evaluate if preoperative changes in solid components impact surgical outcomes.
• To inform surgical timing for partly solid lung tumours based on observed changes.

Main Methods:

• Retrospective analysis of 24 patients with partly solid lung tumours undergoing surgery.
• Patients were categorized into 'No change' (stable solid component for ≥6 months) and 'Change' (increased solid component) groups.
• Comparison of postoperative pathological results and long-term prognosis between the two groups.

Main Results:

• No significant differences in rates of adenocarcinoma in situ, minimally invasive adenocarcinoma, or invasive adenocarcinoma between groups.
• The invasive component size was significantly larger (2.5-fold) in the 'Change' group compared to the 'No change' group.
• No recurrence or cancer-related deaths were observed during a median follow-up of 59 months in either group.

Conclusions:

• Surgical resection outcomes and prognosis are similar for partly solid lung tumours with or without preoperative changes in the solid component.
• Surgery can be deferred for lesions under 3 cm with >50% ground-glass opacity until changes in solid component size or growth are observed.
• This approach may help optimize surgical timing and reduce unnecessary interventions for stable lesions.