Surgical management and outcomes of multifocal ground-glass opacities in elderly patients

Objective To discuss the surgical management and outcomes of multifocal ground-glass opacities (GGO) in elderly patients. Methods The clinical data of 78 elderly patients with multifocal GGO treated in Department of Thoracic Surgery, Huadong Hospital affiliated to Fudan University between January 2011 and January 2013 were retrospectively analyzed. According to the consolidation proportion on preoperative imaging findings, 34 patients were classified into GGO group (GGO-dominant lesion, C/T≤0.5), and 44 in SN-group (solid-dominant lesion, C/T>0.5). The effects of different surgical procedures on survival of patients in two groups were compared, and the factors related to outcomes were analyzed. Results The 3-year survival in sublobar resection group (n=37) was 87.3%, which was not significantly different from that in standard lobectomy group (n=33, 85.6%)(χ2=1.285, P>0.05). The 3-year survival in GGO group was significantly higher than that in SN group (97.1% vs 79.5%, χ2=8.490, P<0.05). The 3-year survival in T1a group was significantly higher than that in T1b group(95.3% vs 77.1%, χ2=0.660, P<0.05). Multivariate analysis demonstrated that nodular diameter and C/T ratio were closely related to prognosis (P<0.05). Conclusions Sublobar resection for multifocal GGO is considered to be an appropriate treatment in the elderly patients as this procedure provides an equivalent long-term outcome in comparison with lobectomy. The nodular diameter and C/T ratio are associated with prognosis. Key words: Lung cancer; Ground-glass opacities; Subsolid nodules; Elder