[Surgery for Pulmonary Multiple Ground Glass Opacities].

Area of Science:

• Pulmonology
• Thoracic Surgery
• Radiology

Background:

• Pulmonary ground glass opacities (GGOs) are increasingly diagnosed, often presenting as multiple nodules.
• The optimal management strategy for multiple GGOs remains controversial.
• GGOs represent diverse pathological entities, including early-stage lung cancers.

Purpose of the Study:

• To clarify the current recommendations for managing multiple pulmonary ground glass opacities.
• To provide guidance on surgical timing and extent for patients with multiple GGOs.

Main Methods:

• Review of current literature and clinical guidelines regarding pulmonary GGO management.
• Analysis of factors influencing surgical decision-making for multiple GGOs.

Main Results:

• Pulmonary GGOs are often indolent, with minimal changes during observation.
• Surgical timing for multiple GGOs should be guided by the predominant nodule.
• Surgery is recommended when the solid component of the predominant nodule measures >5 mm.
• Lobectomy or sub-lobectomy are feasible surgical options; other GGOs may be observed.
• Mediastinal lymph node assessment is indicated for multiple GGOs with high-risk features.

Conclusions:

• Surgical intervention for multiple pulmonary GGOs should be individualized based on the predominant nodule.
• Conservative management with observation is appropriate for non-predominant GGOs.
• Risk stratification is crucial for determining the need for lymph node evaluation.