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. 2024 Jul 30;13(7):1609-1619.
doi: 10.21037/tlcr-24-170. Epub 2024 Jul 25.

Resected lung adenocarcinoma with lymph node metastasis: is ground glass opacity component a prognostic factor?

Chaoqiang Deng #  1   2   3 , Chenyu Jiang #  1   2   3 , Xiangyi Ma #  1   2   3 , Fangqiu Fu  1   2   3 , Shengping Wang  2   3   4 , Yuan Li  2   3   5 , Yang Zhang  1   2   3 , Haiquan Chen  1   2   3
Affiliations

Resected lung adenocarcinoma with lymph node metastasis: is ground glass opacity component a prognostic factor?

Chaoqiang Deng et al. Transl Lung Cancer Res. .

Abstract

Background: Ground glass opacity (GGO)-featured lung adenocarcinoma generally has excellent prognosis, and here is rarely the occurrence of lymph node metastasis. We conducted a retrospective cohort study to explore the prognostic impact of GGO component in node-positive lung adenocarcinomas.

Methods: A total of 669 patients with pathologic N1/N2 lung adenocarcinoma receiving R0 resection and systemic lymph node dissection from 2008 to 2015 were reviewed, including 635 solid and 34 part-solid lesions. Propensity score matching (PSM) was performed to compare survival outcomes of solid and part-solid lesions, in order to determine the prognostic value of GGO component. Cox proportional hazard model was performed to identify significant prognostic factors for resected node positive lung adenocarcinoma.

Results: About 5.1% (34 of 669) of resected node-positive lung adenocarcinoma presented as part-solid nodules on computed tomography (CT) images in this cohort. The median nodule size on CT of the 34 part-solid lesions was 31 mm (range, 15-68 mm), median solid component size on CT was 24 mm (range, 12-62 mm), and median consolidation/tumor ratio was 0.8 (range, 0.64-0.95). After 1:4 PSM, 136 patients and 34 patients were matched from the solid and part-solid groups. No significant difference in either recurrence-free survival (RFS) (P=0.71) or overall survival (OS) (P=0.82) was found between the solid and part-solid groups. Multivariable Cox regression showed that pN stage was the strongest prognostic factor for RFS and OS. GGO component was not an independent prognostic factor toward for RFS [P=0.75; hazard ratio (HR) =0.93; 95% confidence interval (CI): 0.59-1.46] or OS (P=0.53; HR =1.19; 95% CI: 0.69-2.05).

Conclusions: A minority of resected node-positive lung adenocarcinoma presents as GGO component on CT. The presence of GGO component does not predict better prognosis in node-positive lung adenocarcinoma.

Keywords: Ground glass opacity (GGO); lung adenocarcinoma; lymph node metastasis; part-solid nodules; prognosis.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-170/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier curves of 669 patients included in this study, grouped by TNM stages. Recurrence-free survival (A) and overall survival (B) of pathological stage IIB (180 patients), IIIA (433 patients) and IIIB (56 patients) both showed significant differences. Shaded area: 95% confidence interval. TNM, tumor, node, metastasis.
Figure 2
Figure 2
Kaplan-Meier curves of 669 patients included in this study, grouped by with/without GGO component on CT images. Recurrence-free survival (A) and overall survival (B) difference between solid group (635 patients) and part-solid group (34 patients) before 1:4 PSM. Recurrence-free survival (C) and overall survival difference (D) between solid group (136 patients) and part-solid group (34 patients) after 1:4 PSM. None of the curves showed significant differences. Shaded area: 95% confidence interval. GGO, ground glass opacity; CT, computed tomography; PSM, propensity score matching.
See this image and copyright information in PMC

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