Distinct clinicopathologic factors and prognosis based on the presence of ground-glass opacity components in patients with resected stage I non-small cell lung cancer

Chengdi Wang; Yuxuan Wu; Jingwei Li; Pengwei Ren; Ya Gou; Jun Shao; Yaojie Zhou; Xue Xiao; Paierhati Tuersun; Dan Liu; Li Zhang; Weimin Li

doi:10.21037/atm-20-4971

Distinct clinicopathologic factors and prognosis based on the presence of ground-glass opacity components in patients with resected stage I non-small cell lung cancer

Ann Transl Med. 2020 Sep;8(18):1133. doi: 10.21037/atm-20-4971.

Authors

Chengdi Wang¹, Yuxuan Wu¹, Jingwei Li¹, Pengwei Ren¹, Ya Gou¹, Jun Shao¹, Yaojie Zhou¹, Xue Xiao¹, Paierhati Tuersun¹, Dan Liu¹, Li Zhang², Weimin Li¹

Affiliations

¹ Department of Respiratory and Critical Care Medicine, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
² Precision Medicine Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.

Abstract

Background: This study was to investigate the prognostic value of ground-glass opacity(GGO) components and to evaluate distinct the clinicopathological variables of survival outcomes for the pure-GGO, part-solid and solid groups of patients with resected stage I non-small cell lung cancer (NSCLC).

Methods: We retrospectively reviewed the structured data for stage I NSCLC patients who had undergone the curative-intent surgical resection in the Lung Cancer Database of West China Hospital from 2009 to 2016. The eligible patients were divided into the pure-GGO, part-solid and solid groups according to the radiological manifestation. Univariate and multivariate Cox regression analyses were performed between the 3 groups. And we further evaluated the clinicopathological variables in each group separately.

Results: Among a total of 2,775 eligible patients enrolled into the cohort were 1,587 (57.19%) in the solid group, 508 (18.31%) in the part-solid group, and 680 (24.50%) in the pure-GGO group. The 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 98.8% and 98.0% in the pure-GGO group, 96.0% and 86.5% in the part-solid group, and 88.0% and 75.5% in the solid group, respectively (P<0.001). Presence of GGO components was a significantly favorable prognosticator (HR =0.415, 95% CI: 0.286-0.601). Different groups had distinct prognostic factors. LVI was the shared risk factor for groups with presence of GGO components in both part-solid and pure-GGO groups. Pathological stage (IA or IB) was influential exclusively for the pure-GGO group. In the solid group, females, younger patients, and patients without VPI had better survival. But such independent significance did not exist in the other two groups.

Conclusions: GGO component was a strong prognosticator of better prognosis in resected patients with stage I NSCLC. Prognostic factors and survival outcomes were disparate among the pure-GGO, part-solid, and solid group. Our results support the proposal that the next edition tumor-node-metastasis (TNM) classification should consider the importance of GGO components as a new T descriptor.

Keywords: Non-small cell lung cancer (NSCLC); ground-glass opacity (GGO); part-solid nodule; solid nodule; survival analysis.