Abstract

The aim of this study was to investigate a prognostic and clinicopathological impact of ground-glass opacity (GGO) on existing clinical T classification. We analyzed 1228 patients with lung adenocarcinoma classified as clinical stage I who underwent complete resection by lobectomy or pneumonectomy from 2003 to 2013. We divided patients into four groups based on the presence and proportion of GGO by using consolidation-to-tumor ratio (CTR), calculated with the maximum solid component diameter divided by the maximum tumor diameter including GGO area on thin-slice computed tomography; A, CTR ≤0.5; B, 0.5< CTR ≤0.75; C, 0.75< CTR ≤1.0 including GGO; D, GGO negative (pure solid). We compared them on overall survival, pathological findings and histological subtypes in each clinical stage of IA1 to IB. In all clinical stage, we found no significant differences among group A-C on prognosis and pathological findings. The prognosis of each group of A-C was significantly more favorable than that of group D in clinical stage IA2 and IA3. With respect to the pathological findings, group D had significantly larger positive number of N/ly/v in stage IA2 and that of N/pl/v/STAS in stage IA3 than each group of A-C. Group D had significantly less proportion of lepidic component and consisted with more percentile of solid component than each group of A-C in clinical stage IA2-IB. Not proportion but presence of GGO had great impact on prognosis and pathological characteristics. The presence of GGO might as well be included in the next T classification.

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