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The most appropriate and effective treatment for these mGGOs remains controversial. The purpose of this study was to retrospectively review the usefulness and safety of performing video\u2010assisted thoracic surgery (VATS) combined with computed tomography (CT)\u2010guided microwave ablation (MWA) in patients with synchronous multiple primary lung cancer (sMPLC) and to demonstrate the long\u2010term surgical outcomes at our institute.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>From April 2019 to December 2021, we enrolled 47 patients who underwent VATS combined with CT\u2010guided MWA for mGGOs. Comprehensive data regarding the enrolled subjects, including clinical features, imaging findings, histopathological characteristics, and surgical records, were meticulously extracted from the surgical database and electronic medical records. The outcomes assessed in this study included the feasibility and safety profile of the combined procedure, as well as event\u2010free survival (EFS), local progression\u2010free survival (LPFS), and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 47 patients with sMPLC characterized by mGGOs underwent VATS combined with CT\u2010guided MWA. In this cohort, 173 GGOs were removed, including 69 nodules (39.9%) larger than 8\u2009mm and 104 nodules (60.1%) measuring between 5 and 8\u2009mm. We recorded all 58 types of VATS surgeries performed on 83 nodules. Additionally, 90 secondary nodules were treated with CT\u2010guided MWA during either a single hospitalization or multiple hospitalizations (ranging from 1 to 4). We achieved a 100% technical success rate among the 47 patients. During the follow\u2010up, there was no local tumor progression or recurrence among the 47 patients. Event\u2010free survival was 100% at 3\u2009years and 66.82% at 5\u2009years, and the 5\u2010year overall survival rate was 97.5%, with only one patient dying from an unrelated cause.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VATS combined with CT\u2010guided MWA is a safe and effective method for patients with mGGOs. This combination marks the onset of an era where surgeons can utilize both a needle and a scalpel simultaneously.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.70120","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T03:38:49Z","timestamp":1752809929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Outcomes of Video\u2010Assisted Thoracic Surgery Combined With Computed Tomography\u2010Guided Microwave Ablation for Lung Cancer Presenting as Multiple Ground\u2010Glass Opacities: A 5\u2010Year Retrospective Cohort Study"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7738-3455","authenticated-orcid":false,"given":"Bin","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Radiotherapy Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Comprehensive 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