shanghai pulmonary hospital experts consensus on the management of ground glass nodules suspected as lung adenocarcinoma version 1

• DOI: 10.3779/j.issn.1009-3419.2018.03.05
• Publication Date: 2018-03-01
• Authors: Jie Dai; Yuming Zhu; Kaiqi Jin; Lei Zhang; Liang Duan; Shugeng Gao; Yingran Shen; Haifeng Wang; Lanjun Zhang; Xiao Zhou; Jiang Fan; Hui Li; Chang Chen; Gening Jiang; Jingyun Shi; Deping Zhao; Boxiong Xie; Dong Xie; Hongcheng Liu; Xiong Qin; Ke-Neng Chen; Hao Wang; Peng Zhang; Lei Jiang; Wenxin He; Yiming Zhou; Qiankun Chen; Xiao-gang Zhao
• Keywords: China; Consensus; Lung Neoplasms; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; Solitary Pulmonary Nodule; Pulmonary ground-glass nodules; Adenocarcinoma of Lung; Adenocarcinoma; Hospitals; Invasive adenocarcinoma; Physicians; Positron Emission Tomography Computed Tomography; Practice Guidelines as Topic; Humans; Surgery; Adenocarcinoma in situ; Minimal invasive adenocarcinoma; Tomography, X-Ray Computed; RC254-282; Retrospective Studies

Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account. .