WCLC 2025 - Posters & ePosters-P1.07.25 Trajectories of Synchronous Subsolid Nodules in Patients With Resected Subsolid Lung Adenocarcinoma: A Multicenter Cohort Study

P1.07.25 Trajectories of Synchronous Subsolid Nodules in Patients With Resected Subsolid Lung Adenocarcinoma: A Multicenter Cohort Study

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This multicenter retrospective cohort study examined the clinical course and progression risk factors of multiple synchronous subsolid nodules (SSNs) in patients who underwent surgical resection for subsolid lung adenocarcinoma (LUAD) between 2009 and 2019. The study included 409 individuals with multifocal SSNs detected at surgery and followed them until June 2024. Growth of synchronous SSNs was defined by a ≥2 mm increase in total size or solid component or emergence of a new solid component in pure ground-glass nodules (GGNs). Researchers assessed nodule growth, additional lung cancer diagnoses from synchronous SSNs, and mortality outcomes.<br /><br />Key findings indicate that nodule features—specifically part-solid morphology, larger size, presence of bubble lucency, and pleural retraction—are significantly associated with higher risk of nodule progression and subsequent lung cancer diagnosis. However, neither the absolute number of synchronous SSNs nor their mere growth significantly affected lung cancer-related or overall mortality. Approximately 9.7% of nodules demonstrated solid component emergence, and 7.9% were diagnosed as lung cancer during follow-up.<br /><br />Multivariate analysis showed that part-solid nodules had over threefold increased risk for progression. Bubble lucency and pleural retraction were also independent predictors. Younger age, female sex, and never-smoking status influenced progression risk variably. Importantly, many synchronous SSNs remained stable over extended follow-up.<br /><br />The study highlights the need for individualized, nodule-based management of multifocal SSNs rather than relying solely on number or growth. The authors call for defining clinically relevant growth thresholds and developing balanced treatment approaches that account for patient-specific factors to optimize outcomes.<br /><br />In conclusion, nodule characteristics rather than quantity or growth alone should guide the surveillance and treatment of synchronous SSNs in resected subsolid lung adenocarcinoma patients to better stratify progression risk and clinical decision-making.

Asset Subtitle

Seyoung Jung

Meta Tag

Speaker Seyoung Jung

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

multiple synchronous subsolid nodules

subsolid lung adenocarcinoma

nodule progression risk factors

part-solid morphology

bubble lucency

pleural retraction

nodule growth criteria

lung cancer diagnosis

multicenter retrospective cohort study

individualized nodule management