4.6 Article

Ten-Year Follow-up Results of Pure Ground-Glass Opacity-Featured Lung Adenocarcinomas After Surgery

Journal

ANNALS OF THORACIC SURGERY
Volume 116, Issue 2, Pages 230-237

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.athoracsur.2023.01.014

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This study aimed to investigate the long-term outcomes of patients with pure ground-glass opacity (GGO)-featured lung adenocarcinoma 10 years after surgery. The study included 308 cases and found that the 10-year recurrence-free survival rate was 100% and the overall survival rate was 96.9%. Surgery is an effective treatment for curing pure GGO-featured lung adenocarcinoma.
BACKGROUND Previously, we have demonstrated that the 5-year recurrence-free survival after surgery of pure ground-glass opacity (GGO)-featured lung adenocarcinoma is 100%. This study aimed to reveal the long-term outcomes of these patients 10 years after surgery. METHODS Lung adenocarcinoma patients who underwent surgery between December 2007 and December 2013 were reviewed. Patients with pure GGO-featured lung adenocarcinoma were enrolled. Postoperative survival and the risk of developing second primary lung cancer were analyzed. RESULTS Overall, 308 cases of pure GGO-featured lung adenocarcinomas were included. Of these patients, 226 (73.4%) were female, 268 (87.0%) were nonsmokers, and 187 (60.7%) underwent sublobar resection. The median follow-up period after surgery was 112 months. The 10-year recurrence-free survival rate of these patients was 100%, and 10 -year overall survival rate was 96.9%. Both 5-year and 10-year lung cancer-specific survival were 100%. There was no difference in 10-year recurrence-free survival rates between patients who underwent lobectomy or sublobar resection (P = .697). EGFR mutations were detected in 55.6% (84 of 151) of patients who underwent mutational analysis. The risk of developing secondary primary lung cancer for pure GGO-featured lung adenocarcinoma patients at 10 years after resection was 2.4%, and was not correlated with EGFR mutation status (P = .452). CONCLUSIONS No recurrence was observed in patients with pure GGO-featured lung adenocarcinomas 10 years after surgery, even when pathologically evaluated as invasive adenocarcinoma. Pure GGO can be cured by surgery. Surgery is recommended for the appropriate time window with the view to cure. Our study emphasizes that radiologic pure GGO-featured lung adenocarcinomas should be distinguished from other lung adenocarcinomas. (Ann Thorac Surg 2023;116:230-8) & COPY; 2023 by The Society of Thoracic Surgeons. Published by Elsevier Inc.

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