Lymph Node Involvement and Radiologic Predictors of Invasiveness in Pure Ground-Glass Adenocarcinomas: The GORDON...

Area of Science:

• Pulmonary Medicine
• Thoracic Oncology
• Diagnostic Imaging

Background:

• Pure ground-glass opacities (pGGOs) are early lung adenocarcinoma indicators.
• These lesions typically exhibit slow growth and low metastatic potential.
• The study investigates lymph node involvement in pGGO resection patients.

Purpose of the Study:

• To evaluate lymph node involvement incidence in patients undergoing pGGO resection.
• To assess lymph node recurrence-free interval.
• To correlate pGGO radiologic features with final histology and invasiveness.

Main Methods:

• Multicenter retrospective study of 400 patients undergoing pulmonary resection and lymphadenectomy for pGGOs.
• Data collected in the GORDON database (Ground-glass Opacities Retrospective Database for Oncological N-status).
• Analysis included histologic diagnosis, lymph node status, recurrence, and radiologic features using receiver operating characteristic curve analysis.

Main Results:

• No lymph node metastases were detected in 400 pGGOs (86% invasive adenocarcinoma).
• Five-year nodal recurrence rate was 0%.
• Radiologic diameter >18 mm and CT density <-390 HU predicted invasiveness (AUC 0.874).

Conclusions:

• Adenocarcinomas as pGGOs represent low-risk lesions with minimal lymph node involvement or recurrence.
• Lymphadenectomy may not be necessary for pGGOs.
• Preoperative chest CT aids in stratifying lesion invasiveness for tailored treatment.