Prognostic Significance of Ground-Glass Opacity Components in 5-Year Survivors With Resected Lung Adenocarcinoma
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ORIGINAL ARTICLE – THORACIC ONCOLOGY
Prognostic Significance of Ground-Glass Opacity Components in 5-Year Survivors With Resected Lung Adenocarcinoma Shunsuke Shigefuku, MD, PhD, Yoshihisa Shimada, MD, PhD, Masaru Hagiwara, MD, PhD, Masatoshi Kakihana, MD, PhD, Naohiro Kajiwara, MD, PhD, Tatsuo Ohira, MD, PhD, and Norihiko Ikeda, MD, PhD Department of Surgery, Tokyo Medical University, Tokyo, Japan
ABSTRACT Background. Reports on the prognosis for 5-year survivors with lung adenocarcinoma after resection are sparse. This study aimed to identify factors associated with overall survival (OS) and cancer-specific survival (CSS) for 5-year survivors with completely resected lung adenocarcinoma, and to determine whether preoperative imaging factors, including the presence of ground-glass opacity (GGO) components, affect late recurrence in long-term survivors. Methods. Complete resection of lung adenocarcinoma was performed for 1681 patients between January 2000 and December 2013. Of these patients, 936 who survived 5 years or longer after surgery were identified, and factors associated with OS and CSS were determined using the Cox proportional hazard model. Results. Multivariable analysis demonstrated that lymph node metastasis (p \ 0.01) and absence of GGO components (p \ 0.01) were independently associated with OS and CSS for the 5-year survivors. The absence of GGO components was significantly associated with OS (p \ 0.01) and CSS (p \ 0.01) also for the 5-year survivors with stage 1 disease (n = 782) and for the 5-year survivors without recurrence (n = 809). The incidence of recurrence anytime during the 10-year postoperative
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09125-x) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 6 May 2020 Accepted: 3 August 2020 Y. Shimada, MD, PhD e-mail: [email protected]
follow-up period differed significantly between the 5-year survivors with and without GGO components. Conclusions. The absence of GGO components was significantly associated with an unfavorable prognosis for the 5-year survivors with completely resected lung adenocarcinoma regardless whether they had recurrences not.
Lung cancer is the leading cause of cancer-associated mortality worldwide. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers.1,2 Although two-thirds of patients with lung cancer present with locally advanced or metastatic disease at the time of diagnosis,3 surgical resection is the most favorable option for early-stage NSCLC and for appropriately selected locally advanced NSCLC. A large number of reports have described clinicopathologic prognostic factors of early-stage NSCLC patients such as age, sex, smoking history, whole tumor size, lymph node metastasis (pN), blood vessel invasion (BVI), lymphatic permeation, visceral pleural invasion (VPI), tumor differentiation, and presence of ground-glass opacity (GGO) components
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