Sublobectomy and lymph node sampling are adequate for patients with invasive lung adenocarcinoma presenting as pure ground glass nodules

Clin Respir J. 2024 May;18(5):e13766. doi: 10.1111/crj.13766.

Abstract

Purpose: In this study, we aimed to investigate the prognosis of invasive lung adenocarcinoma that manifests as pure ground glass nodules (pGGNs) and confirm the effectiveness of sublobectomy and lymph node sampling in patients with pGGN-featured invasive adenocarcinoma (IAC).

Materials and methods: We retrospectively enrolled 139 patients with pGGN-featured IAC, who underwent complete resection in two medical institutions between January 2011 and May 2022. Stratification analysis was conducted to ensure balanced baseline characteristics among the patients. The 5-year overall survival (OS) and disease-free survival (DFS) rates were compared between the groups using Kaplan-Meier survival curves and log-rank test.

Results: The 5-year OS and DFS rates for patients with IAC presenting as pGGNs after surgery were 96.5% and 100%, respectively. No lymph node metastasis or recurrence was observed in any of the enrolled patients. There was no statistically significant difference in the 5-year OS between patients who underwent lobectomy or sublobectomy, along with lymph node resection or sampling.

Conclusion: IAC presented as pGGNs exhibited low-grade malignancy and had a relatively good prognosis. Therefore, these patients may be treated with sublobectomy and lymph node sampling.

Keywords: lobectomy; lung adenocarcinoma; lymph node dissection; lymph node sampling; pure ground glass nodules; sublobectomy.

MeSH terms

  • Adenocarcinoma of Lung* / mortality
  • Adenocarcinoma of Lung* / pathology
  • Adenocarcinoma of Lung* / surgery
  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms* / mortality
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Lymph Node Excision / methods
  • Lymph Nodes* / pathology
  • Lymph Nodes* / surgery
  • Lymphatic Metastasis*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Pneumonectomy* / methods
  • Prognosis
  • Retrospective Studies
  • Survival Rate / trends