The postoperative outcomes of the dominant lung adenocarcinoma with multiple synchronous ground glass nodules.
Abstract Background Multiple synchronous ground glass nodules (GGNs) are known to be malignant but progress slowly. Multiple synchronous lesions in the same patient show independent characteristics and must be treated individually. Methods This was a retrospective review of 34 lung adenocarcinoma patients with multiple synchronous GGNs in an Asian population. One hundred twenty-seven single lung adenocarcinoma patients were included for comparison. The follow-up period was 5 years for all patients. Results The 5-year overall survival (OS) patients with multiples did not differ from that of patients with single lesion to a statistically significant extent (Single: 81.8% vs. Multiple: 88.2%, P = 0.3602). Dominant tumors (DTs) with a ground glass component and consolidation were divided into three categories based on the consolidation-to-tumor ratio on radiological imaging. No significant differences were observed among the three DT categories. Twenty-four patients had unresected GGNs, progression of the unresected GGN occurred in 10 of these cases. The OS and disease-free survival (DFS) curves of patients with and without GGN progression did not differ to a statistically significant extent (OS: 80% vs. 92.9%, P = 0.3870; DFS: 80% vs. 100%, P = 0.0977). Conclusions The outcomes were best predicted by the stage of the DT. After surgery patients require careful follow-up because unresected GGNs may progress. At the same time, the increase in residual lesions and the appearance of new GGNs were not related to OS. The management should be determined by the DT with the worst prognosis.