Surgical outcomes in lung cancer presenting as ground-glass opacities of 3cm or less: A review of 5 years' experience

Background: High-resolution computed tomography (HRCT) has become increasingly popular recently and more pulmonary ground-glass opacities (GGOs) are being identified. However, the treatment for these GGOs remains controversial. The purpose of this study was to retrospectively review the clinical and pathological characteristics and to demonstrate the longterm surgical outcomes in patients undergoing resection for GGOs in our institute. Methods: From January 2004 to December 2008, we enrolled 50 patients undergoing resection for solitary pulmonary GGOs of 3cm or less at Taipei Veterans General Hospital. Patients with a past history of lung cancer, or multiple GGOs at presentation, or GGOs accompanied by a solid component of more than 50 percent were excluded. The patients were retrospectively reviewed and the rate and circumstances of survival were analyzed. Results: Of the 50 patients, 43 (86%) patients underwent surgery immediately after the GGO lesions were detected by the initial HRCT. Forty-six (92.0%) patients were diagnosed with lung cancer. Of this group, there were 8 (17.4%) adenocarcinomas with lepidic predominant pattern, 13 (28.3%) adenocarcinomas with acinar predominant pattern, and 24 (52.2%) adenocarcinomas with papillary predominant pattern. There was one adenocarcinoma that was mixed with small cell carcinoma. There was no surgical mortality overall, and the 5-year overall and disease-specific survival rates were 97.5% and 100%, respectively. Conclusion: The percentage of malignancy is high in pulmonary GGOs. Surgery results in an excellent prognosis in these patients.