Solitary pulmonary ground-glass opacity: is it time for new surgical guidelines?

As screening for lung cancer becomes more common around the world, so too does detection of pulmonary ground-glass opacities (GGOs). Although a number of guidelines have been published that cover the management of GGOs, they typically feature some common themes. These include basing management and surveillance on a limited number of computed tomography imaging criteria only, inadequate consideration of the pros and cons of non-surgical biopsy versus surgery, inadequate consideration of modern advances in surgery for GGOs and inadequate consideration of potential variations in pathology in different parts of the world. As GGOs become increasingly common in thoracic surgical practice, it may be appropriate to draft new guidelines for the clinical management GGOs that take a more distinctly surgical and international perspective.