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Updated: Jan 18, 2026
Author Spotlight: Advancing 3D Modeling for Enhanced Diagnosis and Treatment of Pulmonary Nodules in Early-Stage Lung Cancer
Published on: October 13, 2023
Trajectories of Synchronous Subsolid Nodules in Patients With Resected Subsolid Lung Adenocarcinoma: A Multicenter
Yeon Wook Kim1, Seyoung Jung2, So Jeong Kim3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Synchronous subsolid nodules (SSNs) in lung adenocarcinoma patients show growth in 16.9%, with specific features predicting progression. Individual nodule characteristics, not the number of SSNs, influence outcomes, guiding personalized management.
Area of Science:
- Pulmonology
- Thoracic Oncology
- Radiology
Background:
- Multifocal subsolid nodules (SSNs) are increasingly detected in lung cancer screening.
- The clinical course of SSNs coexisting with resected subsolid lung adenocarcinoma (LUAD) is not well understood.
- Uncertainty in SSN trajectories complicates optimal management strategies for multifocal lung adenocarcinomas.
Purpose of the Study:
- To evaluate the clinical course and impact of synchronous SSNs in patients with surgically resected subsolid LUAD.
- To identify features associated with SSN progression and subsequent lung cancer diagnosis.
- To inform individualized management strategies for multifocal lung adenocarcinomas.
Main Methods:
- Analysis of synchronous SSNs in patients who underwent surgical resection for subsolid LUAD (2009-2019).
- Longitudinal follow-up (mean 80.6 months) to assess nodule growth and new lung cancer diagnoses.
- Multivariable Cox regression models to identify risk factors for SSN trajectories and mortality.
Main Results:
- 1791 SSNs in 409 patients were analyzed; 16.9% of followed SSNs grew, and 7.9% were diagnosed as early-stage lung cancer.
- Part-solid type, larger size, bubble lucency, and pleural retraction were associated with SSN growth and cancer diagnosis.
- The number of SSNs did not correlate with increased growth risk; SSN number or growth did not significantly impact patient mortality.
Conclusions:
- Synchronous SSNs have variable trajectories, with growth observed in 16.9% of cases.
- SSN characteristics, not quantity, are key predictors of progression and subsequent lung cancer.
- Nodule-based, individualized management and refined growth thresholds are needed for balanced intervention decisions.
