Summary: Patients with stage I non-small cell lung cancer with a small ground-glass opacity (GGO) component on preoperative CT have a significantly better prognosis, including five-year recurrence-free and cancer-specific survival, compared to those with a pure-solid appearance.
Key Takeaways
- Better Prognosis with Minor-GGO: Patients with stage I NSCLC and a minor ground-glass opacity (GGO) component have a significantly better prognosis than those with a solid nodule appearance.
- Importance of Careful Assessment: Radiologists are encouraged to carefully assess CT images for even a minor-GGO component in predominantly solid nodules due to its favorable impact on prognosis.
- Improved Survival Rates: Stage I NSCLC patients with minor-GGO components show significantly better five-year recurrence-free survival (83.4% vs. 55%) and cancer-specific survival (92.4% vs. 76.4%) compared to those with pure-solid nodules.
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Patients with stage I non-small cell lung cancer (NSCLC) who have a small (≤ 10%) ground-glass opacity (GGO) component have a better prognosis than those with a solid appearance, according to a new study appearing in the American Journal of Roentgenology (AJR).
Minor-GGO in Stage I NSCLC
“Radiologists encountering predominantly solid nodules on CT should carefully assess images for even a minor-GGO component, given the favorable prognosis,” noted corresponding author Wei Li, MD, from China’s Shanghai Pulmonary Hospital and Tongji University School of Medicine.
Li and colleagues’ AJR accepted manuscript, accepted by AJR, included 382 patients (mean age 61 years; 210 men, 172 women) who underwent surgical resection for clinical stage I NSCLC between Jan. 1, 2015, and Dec. 31, 2015. Preoperative chest CT showed nodules with a consolidation-to-tumor (CTR) ratio ≥ 0.9 and < 1.0. Two radiologists independently classified the nodules into minor-GGO (CTR ≥ 0.9 and < 1.0) or pure-solid (CTR = 1.0) groups.
Enhances Survival in Stage 1 NSCLC
Ultimately, in clinical stage 1 NSCLCs, those with a minor-GGO component on preoperative CT—compared those having a pure-solid appearance—showed significantly better five-year recurrence-free survival (83.4% vs. 55%; p<.001), as well as significantly better five-year cancer-specific survival (92.4% vs. 76.4%, p =.004).
Featured image: Axial contrast-enhanced CT images on lung windows (A) and mediastinal windows (B) show sub-solid nodule in left upper lobe with total diameter of 2.4 cm (solid line) and diameter of solid component of 2.2 cm (dotted line). CTR was 0.92. Nodule was resected and diagnosed as acinar-predominant adenocarcinoma (acinar component 65%, papillary component 30%, micropapillary component 5%) with epidermal growth factor receptor mutation. Patient showed no evidence of recurrence or cancer-specific death after 81 months of follow-up.
