{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:07:54Z","timestamp":1789103274893,"version":"build-2803163510"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The necessity of lymph node dissection (LND) as part of curative-intent surgery for ground-glass opacity (GGO)-dominant lung adenocarcinoma has been called into question, given the favorable prognosis and indolent behavior of these tumors. However, the oncological safety of omitting LND in cases of GGO-dominant lung adenocarcinoma remains controversial, and current guidelines continue to recommend it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was designed as a retrospective, single-center cohort study. Patients with cT1N0M0 lung adenocarcinoma who underwent surgical resection between 2010 and 2023 were categorized as GGO-dominant or solid-dominant cohorts based on consolidation-to-tumor ratios in preoperative computed tomography scans. The primary endpoint was the incidence of occult lymph node (LN) metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 726 consecutive patients were included in this study, categorized as GGO-dominant in 50 patients and solid-dominant in 676 patients. GGO-dominant tumors were more frequently observed in female patients (p = 0.03), whereas no significant differences were found between the groups with respect to age, smoking status, or ECOG performance status. GGO-dominant morphology was associated with lower pT stage and lower rates of pleural and lymphovascular invasion. The incidence of occult LN metastasis was 4% (n=2) in the GGO-dominant cohort and 11.8% (n=80) in solid-dominant cohort. Only solid tumor size was a significant predictor of occult LN metastasis in multivariable logistic regression (OR 1.39 per 5mm increase, 95% CI 1.10-1.77, p = 0.006). Survival analysis revealed a higher rate of freedom from recurrence (p = 0.04) and favorable trends in overall survival (p = 0.09) and recurrence-free survival (p = 0.086) in the GGO-dominant cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The hypothesis that GGO-dominant morphology reliably predicts negative lymph node involvement was not confirmed. These findings support the continued role of surgical nodal assessment for accurate pathological staging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1937616","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:35:06Z","timestamp":1789101306000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Is surgical lymph node assessment justified for ground glass opacity-dominant lung adenocarcinoma?"],"prefix":"10.3389","volume":"16","author":[{"given":"Benedikt","family":"Niedermaier","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital","place":["Heidelberg, Germany"]},{"name":"Translational Lung Research Center Heidelberg (TLRC-H)","place":["Heidelberg, Germany"]},{"name":"Division of Systems Biology of Signal Transduction, German Cancer Research Center (DKFZ), DKFZ-ZMBH 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