Division of Thoracic Surgery, Department of Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Division of Thoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif.
J Thorac Cardiovasc Surg. 2024 Sep;168(3):631-647.e11. doi: 10.1016/j.jtcvs.2024.02.026. Epub 2024 Jun 14.
Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to review the existing literature and report consensus among a group of multidisciplinary experts, providing specific recommendations for the clinical management of subsolid nodules.
The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary expert panel composed of radiologists, pulmonologists, and thoracic surgeons with established expertise in the management of subsolid nodules. A focused literature review was performed with the assistance of a medical librarian. Expert consensus statements were developed with class of recommendation and level of evidence for each of 4 main topics: (1) definitions of subsolid nodules (radiology and pathology), (2) surveillance and diagnosis, (3) surgical interventions, and (4) management of multiple subsolid nodules. Using a modified Delphi method, the statements were evaluated and refined by the entire panel.
Consensus was reached on 17 recommendations. These consensus statements reflect updated insights on subsolid nodule management based on the latest literature and current clinical experience, focusing on the correlation between radiologic findings and pathological classifications, individualized subsolid nodule surveillance and surgical strategies, and multimodality therapies for multiple subsolid lung nodules.
Despite the complex nature of the decision-making process in the management of subsolid nodules, consensus on several key recommendations was achieved by this American Association for Thoracic Surgery expert panel. These recommendations, based on evidence and a modified Delphi method, provide guidance for thoracic surgeons and other medical professionals who care for patients with subsolid nodules.
表现为影像学亚实性结节的肺癌代表了一种具有独特生物学行为和结局的亚型。本文的目的是回顾现有文献，并报告一组多学科专家的共识，为亚实性结节的临床管理提供具体建议。
美国胸外科学会临床实践标准委员会召集了一个由放射科医生、肺病学家和胸外科医生组成的国际多学科专家小组，他们在亚实性结节的管理方面具有丰富的专业知识。在医学图书馆员的协助下进行了重点文献回顾。根据推荐类别和证据水平，为 4 个主要主题中的每一个主题制定了专家共识声明：（1）亚实性结节的定义（放射学和病理学），（2）监测和诊断，（3）手术干预，和（4）多个亚实性结节的管理。通过改良德尔菲法，整个专家组对这些声明进行了评估和修订。
达成了 17 项建议的共识。这些共识声明反映了基于最新文献和当前临床经验对亚实性结节管理的更新见解，重点关注影像学表现与病理分类之间的相关性、个体化亚实性结节监测和手术策略，以及多个亚实性肺结节的多模态治疗。
尽管在管理亚实性结节的决策过程中存在复杂性，但美国胸外科学会专家组就几个关键建议达成了共识。这些建议基于证据和改良德尔菲法，为治疗亚实性结节的胸外科医生和其他医疗专业人员提供了指导。
