NEW RESEARCH has linked significantly improved outcomes in patients with non-small cell lung cancer (NSCLC) with the presence of ground-glass opacities (GGO) rather than pure-solid nodules on CT lung cancer imaging.
The presence of GGO has been associated with better prognosis in NSCLC patients. However, the impact of a very small GGO component has remained unclear until now. A recent study investigated how even a minor GGO component influences the prognosis of patients with clinical stage I NSCLC. Researchers, led by Dr Meiling Li, from the Shanghai Jiao Tong University School of Medicine in China, conducted a retrospective study analysing 382 patients who underwent surgical resection for clinical stage I NSCLC between January and December 2015. The patients comprised of 210 men and 172 women with a median age of 61 years. The study focused on nodules appearing on preoperative chest CT scans, the noduled were classified into either a minor-GGO group (n=106) or a pure-solid group (n=276), based on the consolidation-to-tumour (CTR) ratio between ≥0.9 and <1.0. The researchers then assessed the recurrence-free survivals and cancer-specific survival by using Kaplan-Meier curves.
Results revealed that minor-GGO nodules, in comparison with pure-solid nodules, had a larger solid component diameters (2.68cm vs. 2.16cm) and total nodule diameters (2.89cm vs 2.16). Additionally, the minor-GGO group exhibited lower frequencies of visceral pleural invasion (6.6% vs. 17.0%), pathologic lymph node involvement (4.7% vs. 20.3%), and epidermal growth factor receptor (EGFR) mutation (71.6% vs 39.9%).
Most importantly, the study demonstrated that patients with minor-GGO nodules had significantly better outcomes. With the five-year recurrence-free survival (RFS) at 83.4% in the minor-GGO group compared to 55.0% in the pure-solid group. Similarly, the five-year cancer-specific survival (CSS) was 92.4% in the minor-GGO group versus 76.4% for the pure-solid group.
The results from this study highlight the importance of meticulous assessment of predominantly solid nodules on CT scans for even a minor-GGO component, given its association with a better prognosis. The researchers encourage radiologists to consider these findings in their evaluations, as they can have substantial implications for the management and treatment of NSCLC patients.
In conclusion, the presence of a minor-GGO component in clinical stage I NSCLC is a positive prognostic factor, significantly associated with improved recurrence-free and cancer-specific survival rates. This research highlights the need for careful imaging assessments to optimize patient outcomes in lung cancer care.
Reference:
Li M et al. Minor (≤ 10%) Ground-Glass Opacity Component in Clinical Stage I Non–Small Cell Lung Cancer: Associations With Pathologic Characteristics and Clinical Outcomes. Am J Roentgenol. 2024
