We evaluated the prognostic role of the presence of a very small ground glass opacity
(GGO) component in stage IA solid-predominant non-small cell lung cancer (NSCLC).
We evaluated surgically resected 1471 patients diagnosed with stage IA solid-predominant
NSCLC. They were classified into 3 groups; that is, GGO group (0.5<CTR<0.9), Very
small GGO group (0.9≤CTR<1.0), and the Solid group (CTR = 1.0). The prognostic influence
of a very small GGO component was evaluated using the Cox proportional hazards model.
Overall survival (OS) was estimated using the Kaplan-Meier method with a log-rank
test. In total, 523 GGO groups, 91 Very small GGO groups, and 857 Solid groups were
identified. The median CTR of the Very small GGO group was 0.92 ± 0.02 (range, 0.90–0.97).
Both the pathological characteristics and survival outcome was similar between GGO
group and Very small GGO group (5 year-OS, 91.7% Vs 89.8%, P = 0.374). However, several pathological findings including nodal involvement (8%
Vs 20%, P = 0.004), lymphatic (12% Vs 27%, P = 0.003) or vascular (18% Vs 37%, P < 0.001) invasion or spread through alveolar space (9% Vs 23%, P = 0.004) were significantly different in comparison between Very small GGO and Solid
group. Accordingly, the 5-year OS significantly differed between the groups (89.8%
Vs 72.5%, P < 0.001), which was also demonstrated in the propensity score-matched cohort (89.4%
Vs 79.2%; P = 0.019). Prognostic impact of a very small GGO component is relevant in stage IA
solid-predominant NSCLC. In the future, it is necessary to confirm these data using
larger multi-institutional datasets that are more appropriately powered.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
CT (computed tomography), GGO (ground-glass opacity), CTR (consolidation tumor ratio), NSCLC (non-small-cell lung cancer), SUVmax (maximum standardized uptake value), PET (positron emission tomography), OS (overall survival), RFS (recurrence-free survival), HR (hazard ratio), CI (confidence interval)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 27, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding statement: This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare Japan, the Smoking Research Foundation, and National Cancer Center Research and Development Fund (26-A-4). Dr Suzuki has received a National Cancer Center Research and Development Fund Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare, Japan. He has also received a research grant and lecture fees from Ethicon, Medtronic, Taiho, and Eli Lilly.
Conflict of Interest: All other authors have no conflicts of interest to disclose.
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