Evaluation of lesions corresponding to ground-glass opacities that were resected after computed tomography follow-up examination.
BACKGROUND
Ground-glass opacity (GGO), which is closely related with bronchioloalveolar carcinoma (BAC), is being detected more frequently. BAC is considered to be a relatively less aggressive tumor, and immediate resection at the time of detection might not be necessary. Therefore, when GGO is detected, a CT follow-up examination is often performed. If growth is detected during the follow-up CT examination, resection is usually considered. However, the possible treatment delay caused by the scheduling of a CT follow-up examination is an issue that must be clarified. Since the cancer might progress during the follow-up period, such follow-up periods might have a negative influence on the patient's prognosis. This study attempted to clarify whether CT follow-up causes treatment delay.


METHODS
A total of 113 lung cancer patients with pure or mixed GGO findings who underwent a resection after a CT follow-up examination between 1999 and 2005 were retrospectively examined. The CT findings at the initial detection, the changes in the CT findings during the CT follow-up period, the histology, the pathological stage and the outcomes after resection were reviewed and evaluated.


RESULTS
The CT finding at the time of the initial detection showed pure GGO in 63 patients and mixed GGO in 50 patients. Histology revealed that adenocarcinoma was found in all 113 patients; squamous cell carcinoma was not found in any of the patients. One-hundred twelve patients were diagnosed as having Stage IA, and a singe patient with visceral pleura invasion was diagnosed as having Stage IB. Complete resections were performed in all the patients. The median postoperative follow-up period was 45.0 months. No recurrences or deaths were observed during the study period.


CONCLUSIONS
No treatment delays or negative influences on patient outcome resulted from the CT follow-up period. A future prospective study should be conducted to establish the optimal CT follow-up program.
Sawada
Shigeki
S
Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Japan. ssawada@shikoku-cc.go.jp
Komori
Eisaku
E
Nogami
Naoyuki
N
Segawa
Yoshihiko
Y
Shinkai
Tetsu
T
Yamashita
Motohiro
M
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed