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Clinical characteristics and prognostic analysis of patients with multifocal ground glass/lepidic lung adenocarcinoma with radiographic progression of residual nodules
Received:June 24, 2022  Revised:July 31, 2022  Click here to download the full text
Citation of this paper:LI Zhao,XU Ke,QIN Lin-lin,ZHAO Xiao-gang.Clinical characteristics and prognostic analysis of patients with multifocal ground glass/lepidic lung adenocarcinoma with radiographic progression of residual nodules[J].Chinese Journal of Clinical Medicine,2022,29(4):529-535
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Author NameAffiliationE-mail
LI Zhao Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China  
XU Ke Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China  
QIN Lin-lin Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China  
ZHAO Xiao-gang Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China ggn_ggo_xiaogang@vip.163.com 
Abstract:Objective To explore the clinical features and survival of multifocal ground glass/lepidic (GG/L) lung adenocarcinoma patients with residual nodules that has radiographic progression (size growth and appearance of solid components). Methods 1 622 patients with multifocal GG/L lung adenocarcinoma with complete clinical data who were diagnosed and treated in Shanghai Pulmonary Hospital, Tongji University from Feb. 2016 to Sep. 2019 were included. Among them, 159 patients had residual nodules with radiographic progression. Baseline characteristics of non-progression group (n=404) and progression group (n=155) were balanced by a 1:3 propensity score matching (PSM). The 5-year overall survival (OS) rate was estimated by Kaplan-Meier analysis. Results 1 622 patients were younger (≤ 65 years, 80.2%), and had more female (67.4%) and non-smoker (89.8%). In terms of tumor characteristics, the epidermal growth factor receptor (EGFR) mutation type was mostly L858R mutation (232, 41.5%). There was no significant difference in clinical characteristics and surgical methods between the progression group and the non-progression group. The 5-year OS rate of 559 patients was 98.5%. There was no statistically significant difference in the 5-year OS rate between the progression group and non-progression group (97.5% vs 100%, P=0.122). Conclusions The overall prognosis of patients with multifocal GG/L lung adenocarcinoma with residual nodules is promising, and residual nodules progression does not affect the prognosis. When radiographic progression of residual nodules is found, further indications for surgical treatment should be evaluated.
keywords:multifocal lung adenocarcinoma  ground glass/lepidic  residual nodule  surgical approach  prognosis
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