Risk Factors of Recurrence in Patients With Clinical Stage IA Adenocarcinoma Presented as Ground-Glass Nodule


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Abstract

Micro-Abstract:Patients in the ground-glass opacity (GGO)-dominant subgroup had a better prognosis than those in solid-dominant subgroup. Multivariate analysis confirmed that consolidation diameter to tumor diameter ratio was an independent risk factor of recurrence. In the analysis of solid-dominant subgroups, limited resection was an independent risk factor of recurrence. As to the GGO-dominant subgroup, surgical type was not a risk factor of recurrence in these patients.Background:In this study we aimed to identify the risk factors of recurrence in patients with clinical stage IA adenocarcinoma presented as ground glass nodule (GGN) on computed tomography scans.Patients and Methods:The study included 245 patients with clinical stage IA adenocarcinoma presented as GGN who underwent surgery during 2010 to 2013. All patients were divided into 2 subgroups on the basis of consolidation diameter to tumor diameter (C/T) ratio on lung window: (1) ground-glass opacity (GGO)-dominant subgroup (C/T ≤ 0.5; n = 179); (2) solid-dominant subgroup (C/T > 0.5; n = 66). Recurrence-free survival (RFS) was analyzed to identify independent risk factors of recurrence using the Kaplan–Meier approach and multivariable Cox models.Results:Patients in the GGO-dominant subgroup had a better prognosis than those in the solid-dominant subgroup (5-year RFS: 98% vs. 87%; P < .001). Multivariate analysis confirmed that C/T ratio was an independent risk factor for RFS in patients with clinical stage IA adenocarcinoma presented as GGN (hazard ratio [HR], 9.47; 95% confidence interval [CI], 1.75–51.1; P = .009). In the analysis of the solid-dominant group, multivariate analysis showed that limited resection was an independent risk factor of recurrence in this subgroup (HR, 6.86; 95% CI, 1.50–31.42; P = .013). Regarding the GGO-dominant subgroup, surgical type was not a risk factor of recurrence.Conclusion:Patients with clinical stage IA solid-dominant adenocarcinoma (C/T ratio > 0.5) had a higher rate of recurrence after limited resection than lobectomy. Thus, limited resection should be performed cautiously in these patients (C/T ratio > 0.5).

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