{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:25:46Z","timestamp":1753878346402,"version":"3.41.2"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission, Adminitrative Commission of Zhongguancun Science Park","doi-asserted-by":"publisher","award":["Z191100006619116"],"award-info":[{"award-number":["Z191100006619116"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subsolid lung nodules represent a distinct group of lung cancers with less\u2010aggressive biological behavior and favorable survival. We aimed to examine the prognostic impact of the ground\u2010glass opacity (GGO) in clinical stage IA (cIA) lung adenocarcinoma with high metabolic activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted among patients with resected hypermetabolic and\/or pure\u2010solid cIA lung adenocarcinoma from a single institution database. The primary outcome was recurrence\u2010free survival (RFS). The secondary outcomes included overall survival, pathological nodal upstaging, and recurrence rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 621 patients were reviewed and classified into three groups: patients with low metabolic, solid nodules (SNs) into group A (<jats:italic>N<\/jats:italic>\u2009=\u2009128), patients with hypermetabolic ground\u2010glass nodules (GGNs) into group B (<jats:italic>N<\/jats:italic>\u2009=\u2009105), and patients with hypermetabolic SNs into group C (<jats:italic>N<\/jats:italic>\u2009=\u2009388). The five\u2010year RFS of group B was significantly better than that of group C in the cT1a\u2009+\u2009T1b (93.3% vs. 72.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) subgroup but not in the cT1c (73.4% vs. 69.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.23) subgroup. Multivariable analysis showed that GGO component was an independent prognostic factor of RFS (hazard ratio [HR]\u2009=\u20090.41, 95% confidence interval [CI]: 0.19\u20130.89, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and protective factor of nodal upstaging (odds ratio [OR]\u2009=\u20090.44, 95% CI: 0.21\u20130.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) among the hypermetabolic subgroup. All except one postoperative recurrence occurred in GGNs with solid component size &gt;\u20092\u2009cm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The presence of GGO component was an independent prognostic factor even in hypermetabolic cIA lung adenocarcinoma. However, the oncologic outcomes of hypermetabolic GGNs were not equally favorable in different T categories.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.15530","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T03:11:07Z","timestamp":1738725067000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reassessment of the Prognostic Implication of Ground\u2010Glass Opacity: An Investigation Into Hypermetabolic Clinical Stage <scp>IA<\/scp> Lung Adenocarcinoma"],"prefix":"10.1111","volume":"16","author":[{"given":"Runze","family":"Li","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing 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