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.