Surgical Extent for Ground Glass Nodules

• Main Author: Suk Ki Cho
• Format: Article
• Language: English
• Published: Korean Society for Thoracic & Cardiovascular Surgery 2021-10-01
• Series: Journal of Chest Surgery
• Subjects: lung neoplasms; ground glass opacity; sublobar resection; surgical extent

As diagnoses of small ground glass nodule (GGN)-type lung adenocarcinoma are increasing due to the increasing frequency of computed tomography (CT) screening, surgical treatment for GGN-type lung adenocarcinoma has rapidly become more common. However, the appropriate surgical extent for these lesions remains unclear; therefore, several retrospective studies have been published and prospectively randomized controlled trials are being undertaken. This article takes a closer look at each clinical study. Convincing evidence must be published on 2 issues for sublobar resection to be accepted as a standard surgical option for GGN lung adenocarcinoma. In the absence of such evidence, it is better to perform lobar resection as long as the patient has sufficient lung function. The first issue is the definition of a sufficient resection margin, and the second is whether lymph node metastasis is conclusively ruled out before surgery. An additional issue is the need for an accurate calculation of the total size and solid size on CT. Given the results of clinical studies so far, wedge resection or segmentectomy shows a good prognosis for GGNs with a total size of 2 cm or less. Therefore, sublobar resection will play a key role even in patients who can tolerate lobectomy.