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

Abstract

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 as: multiple GGN (MG) group: MGs without solid lesions; solid plus GGN (SPG) group: one solid lesion and at least one GGN; multiple solid (MS) group: MS 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.