Management of ground-glass opacity lesions detected in patients with otherwise operable non-small cell lung cancer.
BACKGROUND
When pure ground-glass opacity (GGO) lesions are detected in patients with otherwise operable non-small cell lung cancer, it is controversial whether to resect them simultaneously with the primary tumor or not.


METHODS
We retrospectively reviewed radiologic features and pathologic diagnoses of pure GGO lesions detected in otherwise operable non-small cell lung cancer. Forty lesions were identified in 23 patients. Four of the eight lesions that were simultaneously resected at surgery for the primary tumor turned out to be malignant. During follow-up, four lesions increased in size and were resected later. The remaining 28 lesions were considered nonmalignant because the size did not change or decreased during follow-up. All the lesions were divided into nonmalignant (n = 32) and malignant groups (n = 8), and their clinical and radiologic features were compared.


RESULTS
There was no significant difference in clinical or pathologic findings between the two groups. Median size of the lesions in the nonmalignant group (5 mm) was significantly smaller than in the malignant group (11 mm) (p = 0.001). We tried to predict whether a lesion is benign or malignant based on its size. With a cutoff value of 8 mm, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 88%, 81%, 53%, 96% and 83%, respectively.


CONCLUSIONS
When a pure GGO is detected in otherwise operable lung cancer, it should be resected to rule out the possibility of malignancy if the size is greater than 8 mm. Nevertheless, if the size is less than 8 mm, we suggest that it could be closely followed up using imaging studies.
Kim
Hong Kwan
HK
Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
Choi
Yong Soo
YS
Kim
Kwhanmien
K
Shim
Young Mog
YM
Jeong
Sun Young
SY
Lee
Kyung Soo
KS
Kwon
O Jung
OJ
Kim
Jhingook
J
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome