Hiroyuki Ishikawa MD, Presenter: Nothing to Disclose

Motohiko Yamazaki MD, Abstract Co-Author: Nothing to Disclose

Ryosuke Kunii, Abstract Co-Author: Nothing to Disclose

Norihiko Yoshimura MD, PhD, Abstract Co-Author: Nothing to Disclose

Hidefumi Aoyama, Abstract Co-Author: Nothing to Disclose

Purpose of this study is to evaluate how often non-resected pure ground-glass nodules (pGGN) progress during long-term follow-up period after surgery in the cases of resected multiple lung adenocarcinomas.

Cases of 26 patients with pathologically confirmed multiple lung adenocarcinomas resected surgically between June 2000 and May 2003, including preinvasive lesion of atypical adenomatous hyperplasia and adenocarcinoma in situ, were retrospectively reviewed. Among them, 16 patients (4 men, 12 women; mean age 67.5 years) with one or more pGGN in non-resected lung region were included in this study. Two thoracic radiologists read preoperative high-resolution computed tomography (HRCT) images and pointed out pGGNs in the non-resected lung region by consensus. Then, they read last follow-up HRCT after surgery and assessed interval change of these pGGNs. Progression of pGGN was defined as nodule enlargement more than 2 mm in diameter and/or appearance of solid component in the nodule. Medical records were also assessed for the evaluation of the outcome of these patients.

Size of maximal pGGN in each patient at the preoperative HRCT was 4-30 (median 7, mean 8) mm in diameter. The interval between preoperative and last HRCT examination was 20-127 (median 73.5) months; more than 60 months (long-term group) in 10 patients and less than 60 months (shot-term group) in the other 6. The reason of short-term follow-up period less than 60 months was patient death in 4 and hospital transfer in 2. Progression of pGGN was observed in 6 of 10 patients in long-term group and only one of 6 patients in short-term group. One patient underwent stereotactic radio-surgery for an invasive adenocarcinoma which developed from non-resected pGGN at 68 months after surgery. The others underwent no treatment for these progressing lesions, none of which caused metastasis or patient death.

Non-resected pGGNs often progress during long-term follow-up period more than 5 years after surgery in the cases of resected multiple lung adenocarcinomas.

Long-term follow-up period is necessary to detect progression of non-resected pGGNs in the cases of resected multiple lung adenocarcinomas. Repeat HRCT with short interval is not necessary.

Ishikawa, H, Yamazaki, M, Kunii, R, Yoshimura, N, Aoyama, H, Progression of Non-resected Pure Ground-Glass Nodules in the Cases of Resected Multiple Lung Adenocarcinomas.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12034821.html