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Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors

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Subsolid Lung Adenocarcinomas: Radiological, Clinical and Pathological Features and Outcomes.

Jinglei Lai¹, Qiao Li², Fangqiu Fu¹

¹Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China; Institution of Thoracic Oncology, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

Seminars in Thoracic and Cardiovascular Surgery

|June 4, 2021

Summary

Subsolid lung nodules, classified as pure ground-glass nodules (GGN) and heterogeneous GGN, show excellent prognoses. Real part-solid nodules (rPSN) have a worse recurrence-free survival, with clinical T category and gender impacting outcomes.

Keywords:

Heterogenous ground-glass nodules Lung adenocarcinoma Prognosis Subsolid nodules

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Area of Science:

Pulmonology
Oncology
Radiology

Background:

Subsolid lung nodules in lung adenocarcinoma often present with favorable prognoses.
Radiological and clinicopathological features influence oncological outcomes.
Classification of subsolid nodules aids in predicting patient prognosis.

Purpose of the Study:

To comprehensively investigate the radiological and clinicopathological features of subsolid lung nodules.
To analyze the oncological outcomes based on nodule classification.
To identify prognostic factors for recurrence-free survival in lung adenocarcinoma.

Main Methods:

Retrospective review of 865 patients with surgically resected clinical IA subsolid lung adenocarcinoma.
Classification into pure ground-glass nodules (pGGN), heterogeneous GGN (hGGN), and real part-solid nodules (rPSN) based on imaging characteristics.
Comparison of clinicopathological features and survival times across the three groups.

Main Results:

Tumor size, solid component size, and invasive adenocarcinoma proportion increased significantly from pGGNs to hGGNs to rPSNs.
Adenocarcinomas with lepidic patterns were more common in hGGNs than rPSNs after adjusting for solid component size.
Patients with rPSNs had significantly worse recurrence-free survival (5-year: 91.9%) compared to pGGNs and hGGNs (100%).
Clinical T category and gender were independent prognostic factors for recurrence-free survival in the rPSN group.

Conclusions:

Heterogeneous GGNs represent an intermediate subtype between pGGNs and rPSNs.
Both pGGNs and hGGNs demonstrate excellent oncological outcomes.
rPSNs exhibit a worse prognosis, with clinical T category and gender being significant prognostic indicators.