A first of its kind study led by Shanghai experts confirmed that an active surveillance strategy is safe and reliable for certain types of patients with multiple pulmonary ground-glass opacities, or GGOs, offering an evidence-based alternative to immediate surgery.

A paper about this domestic multi-center clinical research, led by Chen Haiquan, director of the thoracic surgery department at Fudan University Shanghai Cancer Center, was recently published on the website of the Journal of Thoracic Oncology.

The research included 406 patients with a total of 1,496 GGOs. All GGOs included in the study were at the diameter of no more than 2 centimeters and with a consolidation tumor ratio, or CTR, no more than 0.25.

All the GGOs involved in the study are within the "surgical cure window", a concept proposed by Chen's team in June 2024 that refers to a clinical or pathological stage where surgical resection at any time results in a 100 percent five-year survival rate, providing a theoretical basis for active surveillance.

Chen explained that patients in the study underwent annual chest CT follow-ups. If a target lesion showed progression but remained within the "surgical cure window", active surveillance could continue. Surgery was recommended only if the lesion exceeded this window. In this study, eight patients underwent surgical treatment.

The study results showed a 100 percent five-year overall survival rate with no deaths for all the patients involved, confirming the safety and feasibility of this approach to active surveillance in managing multiple GGOs.

"Our team plans to increase the sample size and extend follow-up periods, providing more robust data to support the active surveillance strategy and ultimately benefiting patient," said Chen.