CT imaging features regarding ground-glass nodules and solid lesions reflect prognostication of synchronous multiple lung adenocarcinoma

• Published in: Medicine (Baltimore) Vol. 101; no. 43; p. e31339
• Main Authors: Kou, Jieli, Gu, Xiaofei, Yu, Yang, Zheng, Shugang
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 28.10.2022
• Subjects: Adenocarcinoma of Lung - diagnostic imaging; Humans; Lung Neoplasms - pathology; Observational Study; Retrospective Studies; Solitary Pulmonary Nodule - pathology; Tomography, X-Ray Computed - methods
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000031339

The prognosis of synchronous multiple lung adenocarcinoma (SMLA) dramatically differs due to its nature of multiple primaries or intrapulmonary metastases. This study aimed to assess computed tomography (CT)-reflected SMLA features regarding ground-glass nodules (GGNs) and solid lesions and their correlation with prognostication. One seventy eight SMLA patients who underwent surgical resection were reviewed. According to preoperative CT features, patients were categorized asmultiple GGN (MG) groupMGs without solid lesions; solid plus GGN (SPG) groupone solid lesion and at least one GGN; multiple solid (MS) groupMS lesions, with or without GGNs. Clinical characteristics, disease-free survival (DFS), and overall survival (OS) were retrieved. Largest tumor size (P < .001) and lymph-node metastasis prevalence (P < .001) were different among three groups, which were highest in the MS group, followed by the SPG group, and lowest in the MG group. Besides, the dominant tumor subtype also varied among the three groups (P < .001), while no difference in other clinical characteristics was discovered. DFS was more deteriorative in the MS group compared to the SPG group (P = .017) and MG group (P < .001), while of no difference between the SPG group and MG group (P = .128). Meanwhile, OS exhibited similar treads among the three groups. Besides, after multivariate Cox analyses adjustment, MS versus MG independently correlated with DFS (P = .030) and OS (P = .027), but SPG versus MG did not. In conclusion, preoperative CT-imaging MS lesions reflect advanced disease features and poor prognosis compared to MG and solid lesion plus GGN in SMLA patients who underwent surgical resection.