Subsolid lesions exceeding 3 centimeters: the ground-glass opacity component still matters

2021 
Abstract Background Recent studies on the favorable prognosis of ground-glass opacities (GGO) featured lung adenocarcinoma compared with solid nodules were limited to small tumors measuring ≤3.0 cm. This study aimed to investigate whether GGO component could predict better prognosis in patients with large subsolid lesions exceeding 3cm compared with small solid nodules within the same clinical T category. Methods From 2010 to 2015, a total of 1010 patients with completely resected clinical N0 lung adenocarcinoma were enrolled, including 860 solid lesions and 150 subsolid lesions exceeding 3cm. To analyze the prognostic significance of GGO component, propensity score matching adjusting solid component size was performed. Results After propensity score matching, 144 pairs of patients were finally analyzed. The mean size of the solid component was 23.7mm in the GGO group and 24.4mm in the solid group(p=0.450). The GGO group had significantly better overall survival and recurrence-free survival (p=0.011 and p=0.003, respectively), which were also validated in patients with solid-predominant lesions. Subgroup analysis showed the GGO group was associated with better prognosis in each clinical T category. Conclusions The prognosis of patients with GGO lesions exceeding 3cm was better than that of patients with small solid lesions even within the same clinical T category. Clinical T classification incorporating GGO component may provide better prognostic prediction for patients with lung cancer exceeding 3cm.
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