Does ground glass opacity-dominant feature have a prognostic significance even in clinical T2aN0M0 lung adenocarcinoma?

Abstract

Introduction: Recent studies have demonstrated that ground glass opacity (GGO)-dominant tumors correspond to pathologically low-grade adenocarcinomas and that patients with resected tumors have an excellent prognosis. However, almost all of those studies were limited to tumors measuring ≤3.0cm. The purpose of this study was to characterize lung adenocarcinomas >3.0cm in diameter with GGO-dominant features and evaluate the prognosis of patients with such tumors.

Methods: One hundred and thirteen patients with cT2aN0M0 lung adenocarcinoma underwent surgical resection between 2005 and 2011. Twenty-five had tumors with a ≥50% GGO component (GGO-dominant group) and the remaining had solid-dominant tumors (Solid-dominant group). The clinicopathological findings and prognosis of the two groups were evaluated.

Results: The tumors in the GGO-dominant group rarely exhibited pathological invasiveness, such as lymphatic (n=1), vascular (n=0) and pleural invasion (n=5) or lymph node metastasis (n=0). On the other hand, the tumors in the solid-dominant group frequently exhibited pathological invasiveness, including lymphatic (n=26), vascular (n=16) and plural invasion (n=52) and lymph node metastasis (n=18). There were significant differences in all of the characteristics between the two groups (lymphatic; p=0.0026, vascular; p=0.0214, and pleural invasion; p=0.0004, and lymph node metastases; p=0.0086, respectively). In the GGO-dominant group, 24 patients were alive without recurrence, while the remaining died of another cancer. Recurrence occurred in 34 patients in the solid-dominant group, and 16 died of the disease. The 5-year survival rate was 96% in the GGO-dominant group, compared to 71% in the solid-dominant group (p=0.0120).

Conclusions: In the GGO-dominant group, the malignant potential was low and the patients had a favorable prognosis after surgery, similar to the patients with GGO-dominant tumors diagnosed as cT1a-bN0M0.

Keywords: Adenocarcinoma; GGO-dominant tumor; Ground glass opacity; High-resolution computed tomography; Lepidic growth pattern; Lung cancer.