Author of

• 14409

  +

  P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Localized Disease - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 14422

    +

    P2.02-013 - Strategy of Management for Synchronous Pure GGOs Detected in Patients Undergoing Resection for Primary NSCLC (ID 2599)

    09:30 - 17:00  |  Author(s): Y. Ren
    • Abstract

    Background:
    It is quite common to discover some synchronous pure ground-glass opacity (GGO) nodules in other lobes beside the operable primary tumor on initial CT scans, while the appropriate surgical strategy for these pure GGOs remains controversial.
    
    Methods:
    We included patients with primary tumor lesion and pure GGOs in different lobes between June 2010 and December 2013. The radiographic manifestations of all GGOs, pathologic features of resected GGOs and follow-up outcomes of unresected GGOs were analyzed to make clear which GGOs should be resected concomitantly with the primary tumor.
    
    Results:
    A total of 59 patients with 72 pure GGOs were included, of which, 29 were resected at the primary surgery and 43 were left behind and followed up. In the resection group, 8 (27.6%) were invasive or minimally invasive lesions, 12 (41.4%) were preinvasive lesions and 9 (31%) were benign lesions. In the follow-up group, 7 nodules grew, and the growth rate was 16.3% (7 of 43) on a per-nodule basis, and 19.4% (7 of 36) on per-person basis. In all, concomitant resection at the primary surgery was considered for 15 of 72 GGOs (8 malignant lesions and 7 growth lesions). Multivariate analysis showed that the initial size was an independent risk factor for these GGOs (P=0.011), and a cut-off value was calculated as 9.9 mm by receiver operating curve (ROC) curve analysis. Tabel Predictors for synchronous GGO nodules which need concomitant resection

    	Univariate analysis		Multivariate analysis
    	P value	OR	P value	OR
    Age at operation	0.056	1.075	0.872	1.01
    Sex	0.279	0.527
    Smoking	0.136	2.667
    Size	<0.001	18.733	0.011	10.922
    Location
    LUL		Reference
    LLL	0.345	0.333
    RUL	0.217	0.381
    RML	0.577	1.778
    RLL	0.886	0.889
    Location of primary lesion
    Ipsilateral		Reference
    Contralateral	0.334	1.8
    Shape
    Round		Reference
    Oral	0.584	1.625
    Irregular	0.349	2.275
    Margin
    Smooth		Reference
    Lobulated	0.629	1.4
    Spiculated	0.125	3.111
    Air bronchogram	0.001	8	0.355	2.199
    Bubble lucency	0.024	6.545	0.274	3.356
    Pleural tag	0.006	6.933	0.175	3.724

    Figure 1
    
    
    
    Conclusion:
    About 20% of synchronous pure GGO nodules should need surgical treatment at the time of primary operation, and a lesion size of more than 9.9 mm is an effective discriminator of these GGOs. As to the unresected GGOs, a close follow-up is always indispensible.