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Multicenter Study
. 2025 Nov 6;40(11):ivaf260.
doi: 10.1093/icvts/ivaf260.

Prognostic Impact of Ground-Glass Opacity in Clinical Stage IA Non-Small Cell Lung Cancer With Interstitial Lung Abnormalities

Norifumi Tsubokawa  1 , Takahiro Mimae  1 , Takeshi Mimura  2 , Atsushi Kagimoto  2 , Atsushi Kamigaichi  1 , Yoshihiro Miyata  1 , Morihito Okada  1
Affiliations
Multicenter Study

Prognostic Impact of Ground-Glass Opacity in Clinical Stage IA Non-Small Cell Lung Cancer With Interstitial Lung Abnormalities

Norifumi Tsubokawa et al. Interdiscip Cardiovasc Thorac Surg. .

Abstract

Objectives: Ground-glass opacity (GGO) component is a favourable prognostic factor in non-small cell lung cancer (NSCLC), whereas NSCLC with interstitial lung abnormalities (ILA) generally has poorer prognoses. We investigated the clinical significance of GGO in patients with NSCLC and ILA.

Methods: Among 1319 patients who underwent pulmonary resection for clinical stage IA NSCLC at 2 institutions between 2010 and 2020, we retrospectively assessed 216 patients with ILA based on preoperative CT. Patients were divided into 2 groups: pure solid tumours without GGO and subsolid tumours with GGO.

Results: Among 216 patients with ILA, 146 (68%) had pure solid tumours and 70 (32%) had subsolid tumours. Subsolid tumours had significantly better prognoses than pure solid tumours (5-year overall survival, 69.7% vs 48.6%, P = .0008; 5-year recurrence-free survival, 69.7% vs 42.3%, P < .0001). Recurrence occurred in 4 patients (6%) with subsolid tumours and 41 (28%) with pure solid tumours. Although the 5-year cumulative incidence of lung cancer deaths was significantly lower in subsolid tumours than in those with pure solid tumours (2.6% vs 23.6%, P = .0011), an increase in other causes of mortality after 2 years post-surgery in subsolid tumours resulted in a comparable 5-year cumulative incidence of other causes of death (28.4% vs 36.1%, P = .260).

Conclusions: In clinical stage IA NSCLC with ILA, subsolid tumours have a lower lung cancer mortality than pure solid tumours; however, higher other-cause mortality after 2 years contributes to poorer overall survival. Optimizing comorbidity management may improve long-term prognosis.

Keywords: ground-grass opacity; interstitial lung abnormalities; non-small cell lung cancer.

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Conflict of interest statement

None declared.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Overall Survival (A) and Recurrence Free Survival (B) Between Pure Solid and Subsolid Tumors. The coloured area indicates the 95% confidence interval
Figure 2.
Figure 2.
Cumulative Incidence of Recurrence Between Pure Solid and Subsolid Tumors. The coloured area indicates the 95% confidence interval
Figure 3.
Figure 3.
Cumulative Incidence of Lung Cancer Death (A) and Other Causes of Death (B) Between Pure Solid and Subsolid Tumors. The coloured area indicates the 95% confidence interval. CI, Cumulative Incidence
See this image and copyright information in PMC

References

    1. Putman RK, Hatabu H, Araki T, et al. ; COPDGene Investigators. Association between interstitial lung abnormalities and all-cause mortality. JAMA. 2016;315:672-681. 10.1001/jama.2016.0518 - DOI - PMC - PubMed
    1. Tomassetti S, Gurioli C, Ryu JH, et al. The impact of lung cancer on survival of idiopathic pulmonary fibrosis. Chest. 2015;147:157-164. 10.1378/chest.14-0359 - DOI - PubMed
    1. Tsutani Y, Mimura T, Kai Y, et al. Outcomes after lobar versus sublobar resection for clinical stage I non-small cell lung cancer in patients with interstitial lung disease. J Thorac Cardiovasc Surg. 2017;154:1089-1096.e1. 10.1016/j.jtcvs.2017.03.116 - DOI - PubMed
    1. Wu Y-L, Tsuboi M, He J, et al. ; ADAURA Investigators. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med. 2020;383:1711-1723. 10.1056/NEJMoa2027071 - DOI - PubMed
    1. Wu YL, Dziadziuszko R, Ahn JS, et al. ; ALINA Investigators. Alectinib in resected ALK-positive non-small-cell lung cancer. N Engl J Med. 2024;390:1265-1276. 10.1056/NEJMoa2310532 - DOI - PubMed

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