Persistent Pulmonary GGNs Are Likely in Adenocarcinoma Spectrum

Background: Management of pulmonary ground-glass nodules (GGNs) that increase in size is subject to debate whether continued surveillance or surgery is best practice. Objective: To evaluate long-term survival and appropriateness of surveillance versus surgery for GGNs, especially those that increase in size during follow-up. Design: Nonrandomized, real-world, prospective observational study. Participants/Methods: Patients with GGNs identified on CT were included. Groups comprised all individuals with GGNs, stable GGNs, and GGNs that increased in size. This study had 8 years and 9 months of follow-up. The primary end point was overall survival (OS), and the secondary end point was recurrence-free survival. Cost and duration of surgery were also analyzed. Propensity score matching was used to balance baseline characteristics between groups. Results: 1003 GGNs in 684 individuals were evaluated. Among these, 40 patients had GGNs that developed solid components, while 644 patients’ more...