Review of sublobar resection for lung adenocarcinoma with ground-glass presence

Abstract

Surgery is the mainstay of lung cancer treatment options. Traditionally, lobectomy has held its place as the gold standard for treating localized lung cancer, while sublobar resection, including wedge resection and segmentectomy, was primarily considered as an alternative, often reserved for patient ineligible to sustain a radical intervention. However, with the widespread application of computed tomography (CT) to clinical practice, the increasing detection rate of pulmonary ground glass nodules (GGNs) has reshaped this landscape. Ground glass opacity (GGO) in persistent lung nodules is an indicative factor of a favorable prognosis, typically corresponding to pathological changes such as atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), or adenocarcinomas predominantly featuring a lepidic growth pattern. A large number of retrospective studies have shown that sublobar resection can achieve satisfactory therapeutic outcomes for such lesions. A series of prospective studies from Japan have confirmed that for early-stage lung cancers dominated by GGOs, sublobar resection is also a viable curative surgical option. The follow-up data showed that there was no statistical difference in the survival status of these patients compared with that of pulmonary lobectomy. This article aims to delve into the role of limited lung resection in the context of lung adenocarcinoma presenting with GGO features.

Keywords

• non-small cell lung cancer
• lung adenocarcinoma
• pulmonary ground-glass nodule
• sublobar resection