• James Huang, Kay See Tan, Nasser Altorki, Mara Antonoff, Shanda Blackmon, Raphael Bueno, Bryan Burt, Todd Demmy, Nathaniel Evans, Laura Donahoe, David Harpole, Doraid Jarrar, Benjamin Kozower, Michael Lanuti, Moishe Liberman, Jules Lin, Douglas Liou, Michael Liptay, James Luketich, Arjun Pennathur, Gerard Petersen, Robert Ripley, Matthew Rochefort, Christopher W Seder, Joseph Shrager, Stacey Su, Betty Tong, Yaron Shargall, Ara Vaporciyan, Thomas Waddell, Benny Weksler, Dennis Wigle, Sai Yendamuri, and David R Jones.
• Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: huangj@mskcc.org.
• J. Thorac. Cardiovasc. Surg. 2024 Oct 10.

ObjectivePresentation with multiple ground-glass opacities (GGOs) is an increasingly common occurrence, and the optimal management of these lesions is unclear. Active surveillance has been increasingly adopted as a management strategy for other low-grade malignancies. We hypothesized that active surveillance could be a feasible and safe option for patients with multiple GGOs.MethodsPatients with ≥2 GGOs (ground-glass predominant, <50% solid, ≤3 cm) were enrolled in a multi-institutional registry and prospectively followed up on active surveillance with computed tomography scans every 6 to 12 months. Each GGO was catalogued and measured individually at each follow-up visit.ResultsTarget accrual was met, with 337 patients from 23 institutions. The mean age was 70 years (interquartile range, 65-77 years), and 74% were women. Most were former (70%) or current (9%) smokers, with a mean exposure of 30 pack-years (interquartile range [IQR], 15-44 pack-years). One half of the patients (51%) had a previous lung cancer, and the majority (86%) were already under surveillance at the time of study entry. The median number of GGOs per patient was 3 (IQR, 2-5), with a total of 1467 GGOs under surveillance. The median GGO size was 0.9 cm (IQR, 0.7-1.3 cm). Most GGOs were 0.5 to 1 cm in size.ConclusionsActive surveillance, rather than immediate intervention, was an acceptable option to patients, and accrual to this registry trial was feasible. Safety end points and long-term outcomes will be assessed in the planned 5-year follow-up in accordance with the protocol.Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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