Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China; Institute of Thoracic Oncology, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Institute of Thoracic Oncology, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
Ann Thorac Surg. 2023 Aug;116(2):230-237. doi: 10.1016/j.athoracsur.2023.01.014. Epub 2023 Jan 13.
Previously, we have demonstrated that the 5-year recurrence-free survival after surgery of pure ground-glass opacity (GGO)-featured lung adenocarcinoma is 100%. This study aimed to reveal the long-term outcomes of these patients 10 years after surgery.
Lung adenocarcinoma patients who underwent surgery between December 2007 and December 2013 were reviewed. Patients with pure GGO-featured lung adenocarcinoma were enrolled. Postoperative survival and the risk of developing second primary lung cancer were analyzed.
Overall, 308 cases of pure GGO-featured lung adenocarcinomas were included. Of these patients, 226 (73.4%) were female, 268 (87.0%) were nonsmokers, and 187 (60.7%) underwent sublobar resection. The median follow-up period after surgery was 112 months. The 10-year recurrence-free survival rate of these patients was 100%, and 10-year overall survival rate was 96.9%. Both 5-year and 10-year lung cancer-specific survival were 100%. There was no difference in 10-year recurrence-free survival rates between patients who underwent lobectomy or sublobar resection (P = .697). EGFR mutations were detected in 55.6% (84 of 151) of patients who underwent mutational analysis. The risk of developing secondary primary lung cancer for pure GGO-featured lung adenocarcinoma patients at 10 years after resection was 2.4%, and was not correlated with EGFR mutation status (P = .452).
No recurrence was observed in patients with pure GGO-featured lung adenocarcinomas 10 years after surgery, even when pathologically evaluated as invasive adenocarcinoma. Pure GGO can be cured by surgery. Surgery is recommended for the appropriate time window with the view to cure. Our study emphasizes that radiologic pure GGO-featured lung adenocarcinomas should be distinguished from other lung adenocarcinomas.
此前，我们已经证明，纯磨玻璃密度（GGO）特征性肺腺癌手术后 5 年无复发生存率为 100%。本研究旨在揭示这些患者手术后 10 年的长期结果。
回顾 2007 年 12 月至 2013 年 12 月期间接受手术的肺腺癌患者。纳入纯 GGO 特征性肺腺癌患者。分析术后生存和发生第二原发性肺癌的风险。
总体而言，共纳入 308 例纯 GGO 特征性肺腺癌患者。其中，226 例（73.4%）为女性，268 例（87.0%）为不吸烟者，187 例（60.7%）行亚肺叶切除术。术后中位随访时间为 112 个月。这些患者的 10 年无复发生存率为 100%，10 年总生存率为 96.9%。5 年和 10 年肺癌特异性生存率均为 100%。行肺叶切除术和亚肺叶切除术的患者 10 年无复发生存率无差异（P=0.697）。对 151 例患者进行突变分析，其中 55.6%（84 例）检测到 EGFR 突变。切除后 10 年，纯 GGO 特征性肺腺癌患者发生第二原发性肺癌的风险为 2.4%，与 EGFR 突变状态无关（P=0.452）。
纯 GGO 特征性肺腺癌患者手术后 10 年未观察到复发，即使病理评估为浸润性腺癌。纯 GGO 可通过手术治愈。建议在适当的时间窗内进行手术以达到治愈的目的。本研究强调，影像学上的纯 GGO 特征性肺腺癌应与其他肺腺癌区分开来。
