Prevalence of Invasive Lung Cancer in Pure Ground Glass Nodules Less Than 30 mm: A Systematic Review

This article examines the malignancy potential of pure ground-glass nodules (pGGNs) under 30 mm, challenging the notion that these nodules carry minimal invasive cancer risk. After analyzing 28 observational studies with a total of 3,874 nodules, the study found a pooled prevalence of invasive or minimally invasive adenocarcinoma in 42.4 percent of cases. The study highlights significant variability in malignancy risk, primarily driven by patient selection rather than nodule size or geographic region. Current classification systems, such as the IASLC's, which label such nodules as "probably benign,” may underestimate their true invasive potential. 
 
This research is pivotal for the cardiothoracic surgery community, as it underscores the need for vigilance in managing small pGGNs. These findings could influence preoperative planning, surgical decision-making, and guideline revisions to improve lung cancer outcomes.