Persistent part-solid nodules with solid part of 5 mm or smaller: Can the ‘follow-up and surgical resection after interval growth’ policy have a negative effect on patient prognosis?

Objective To investigate whether “follow-up and surgical resection after interval growth” can negatively influence recurrence or mortality in patients with persistent part-solid nodules (PSNs) with solid components ≤5 mm. Methods One hundred twenty five surgically resected persistent PSNs with solid components ≤5 mm in 125 individuals were evaluated. Of the 125 PSNs, 54 and 71 PSNs were categorized into interval growth and immediate surgery groups, respectively. Cox regression analysis was performed to evaluate the association of “follow-up until interval growth” with recurrence and survival, adjusted for initial clinical and CT features. Results In the interval growth group, 30 patients showed increased nodule size, 10 increased solid parts, and the remaining 14 both patterns. Five patients showed clinical stage shifts (stage T1a, initially, to T1b after interval growth). Post-operative disease recurrence occurred in six individuals (interval growth group, n = 2/54; immediate surgery group, n = 4/71), and four individuals died (interval growth group, n = 1/54; immediate surgery group, n = 3/71). There were no significant differences between these two groups in terms of recurrence-free survival ( p = 0.451) and overall survival ( p = 0.185). Conclusion “Follow-up and surgical resection after interval growth” did not negatively influence the prognosis of patients with persistent PSNs with solid components ≤5 mm. Key Points • Incidences of post-operative recurrence or death in patients with PSN are low. • “Follow-up until interval growth” of PSNs does not negatively influence disease recurrence. • There was no survival disadvantage related with “follow-up until interval growth” in PSNs.