Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
Eur J Cardiothorac Surg. 2024 Aug 2;66(2). doi: 10.1093/ejcts/ezae291.
Ground-glass nodules-featured lung cancer have been identified in some teenagers in recent years. This study aims to investigate the characteristics and surgical outcomes of these patients and explore proper management strategy.
Patients aged ≤20 with incidentally diagnosed lung cancer were retrospectively reviewed from February 2016 to March 2023. Based on lymph node evaluation status, these patients were divided into non-lymph node evaluation and lymph node evaluation groups. The clinical and pathological characteristics were analysed.
A total of 139 teenage patients were included, with an obviously increased cases observed from 2019, corresponding to the COVID-19 pandemic. The median age of the 139 patients was 18 years (range 12-20). Eighty-five patients had pure ground-glass nodules, while others had mixed ground-glass nodules. The mean diameter of nodules was 8.87 ± 2.20 mm. Most of the patients underwent wedge resection (64%) or segmentectomy (31.7%). Fifty-two patients underwent lymph node sampling or dissection. None of these patients had lymph node metastasis. The majority of lesions were adenocarcinoma in situ (63 cases) and minimally invasive adenocarcinoma (72 cases), while four lesions were invasive adenocarcinoma. The median follow-up time was 2.46 years, and none of these patients experienced recurrence or death during follow-up. The lymph node evaluation group had longer hospital stays (P < 0.001), longer surgery time (P < 0.001), and greater blood loss (P = 0.047) than the non-lymph node evaluation group.
The COVID-19 pandemic significantly increased the number of teenage patients incidentally diagnosed with lung cancer, presenting as ground-glass nodules on CT scans. These patients have favourable surgical outcomes. We propose a management strategy for teenage patients, and suggest that sub-lobar resection without lymph node dissection may be an acceptable surgical procedure for these patients.
近年来，一些青少年中发现了具有磨玻璃结节特征的肺癌。本研究旨在探讨这些患者的特征和手术结果，并探索合适的管理策略。
回顾性分析 2016 年 2 月至 2023 年 3 月期间偶然诊断为肺癌且年龄≤20 岁的患者。根据淋巴结评估情况，将这些患者分为非淋巴结评估组和淋巴结评估组。分析其临床和病理特征。
共纳入 139 例青少年患者，其中 2019 年明显增加，与 COVID-19 大流行相对应。139 例患者的中位年龄为 18 岁（范围 12-20 岁）。85 例患者为单纯磨玻璃结节，其余为混合磨玻璃结节。结节的平均直径为 8.87±2.20mm。大多数患者行楔形切除术（64%）或节段切除术（31.7%）。52 例行淋巴结采样或切除术。这些患者均无淋巴结转移。多数病变为原位腺癌（63 例）和微浸润性腺癌（72 例），4 例为浸润性腺癌。中位随访时间为 2.46 年，随访期间患者均无复发或死亡。淋巴结评估组的住院时间（P<0.001）、手术时间（P<0.001）和出血量（P=0.047）均长于非淋巴结评估组。
COVID-19 大流行显著增加了偶然诊断为肺癌的青少年患者数量，这些患者 CT 扫描表现为磨玻璃结节。这些患者的手术结果良好。我们提出了一种针对青少年患者的管理策略，建议对于这些患者，可行不进行淋巴结清扫的亚肺叶切除术。
