Management of Multiple Pure Ground-Glass Opacity Lesions in Patients with Bronchioloalveolar Carcinoma

Introduction: The objective of this study was to evaluate the clinical characteristics and long-term outcome of multiple pure ground-glass opacity (GGO) lesions detected in patients undergoing pulmonary resection for bronchioloalveolar carcinoma (BAC). Methods: Between January 2000 and December 2007, 73 patients underwent pulmonary resection for BAC. Of those, 23 patients had multiple pure GGOs on their preoperative computed tomography (CT) scans. Eighty-nine GGO lesions were detected with a median number of 3 (range, 2-11) per patient. Resection included wedge resection in 12 patients, lobectomy in 7, lobectomy with wedge resection in 3, and bilobectomy in 1. Five patients had all GGOs lesions resected (group 1), whereas 18 had some of the GGO lesions resected and the remaining lesions followed by serial CT scans (group 11). Median follow-up was 40.3 months. Results: No late death occurred during the follow-up period. In group 1, four patients had no recurrences and one patient developed a new lesion that was resected and found to be adenocarcinoma. In group 11, GGO lesions either did not change in size (n = 15) or disappeared (n = 3) in all patients. No GGO lesions increased in size or developed a solid component during the follow-up period. Conclusions: When multiple pure GGO lesions in patients with BAC remained without surgical resection, there was no change in their size or features during follow-up. When it is not feasible to resect all GGO lesions in patients with multifocal BAC, close follow-Lip using CT scans represents an alternative to surgical resection.