The 2023 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Management of subsolid lung nodules Guidelines
| Authors: | Chen, H.; Kim, A. W.; Hsin, M.; Shrager, J. B.; Prosper, A. E.; Wahidi, M. M.; Wigle, D. A.; Wu, C. C.; Huang, J.; Yasufuku, K.; Henschke, C. I.; Suzuki, K.; Tailor, T. D.; Jones, D. R.; Yanagawa, J. |
| Title: | The 2023 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Management of subsolid lung nodules |
| Abstract: | Objective: Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to review the existing literature and report consensus among a group of multidisciplinary experts, providing specific recommendations for the clinical management of subsolid nodules. Methods: The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary expert panel composed of radiologists, pulmonologists, and thoracic surgeons with established expertise in the management of subsolid nodules. A focused literature review was performed with the assistance of a medical librarian. Expert consensus statements were developed with class of recommendation and level of evidence for each of 4 main topics: (1) definitions of subsolid nodules (radiology and pathology), (2) surveillance and diagnosis, (3) surgical interventions, and (4) management of multiple subsolid nodules. Using a modified Delphi method, the statements were evaluated and refined by the entire panel. Results: Consensus was reached on 17 recommendations. These consensus statements reflect updated insights on subsolid nodule management based on the latest literature and current clinical experience, focusing on the correlation between radiologic findings and pathological classifications, individualized subsolid nodule surveillance and surgical strategies, and multimodality therapies for multiple subsolid lung nodules. Conclusions: Despite the complex nature of the decision-making process in the management of subsolid nodules, consensus on several key recommendations was achieved by this American Association for Thoracic Surgery expert panel. These recommendations, based on evidence and a modified Delphi method, provide guidance for thoracic surgeons and other medical professionals who care for patients with subsolid nodules. © 2024 The Authors |
| Keywords: | cancer survival; cancer surgery; cancer recurrence; cancer staging; follow up; lymph node metastasis; diagnostic accuracy; sensitivity and specificity; clinical practice; consensus; lung lobectomy; lung adenocarcinoma; radiologist; conservative treatment; artificial intelligence; measurement; brain metastasis; medline; medical literature; clinical practice guideline; radiofrequency ablation; stereotactic body radiation therapy; lung biopsy; predictive value; surveillance; lung lesion; lung nodule; non small cell lung cancer; surgical margin; randomized controlled trial (topic); ground glass opacity; clinical outcome; thermal ablation; lung adenoma; wedge resection; adenocarcinoma in situ; atypical adenomatous hyperplasia; ground-glass opacity; low-dose computed tomography; human; article; pulmonologist; multidisciplinary team; radiomics; thoracic surgeon; non–small cell lung cancer; microwave thermotherapy; medical subject headings; coronavirus disease 2019; positivity rate; subsolid; surgical strategy; thin-section computed tomography |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 168 |
| Issue: | 3 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2024-09-01 |
| Start Page: | 631 |
| End Page: | 647.e11 |
| Language: | English |
| DOI: | 10.1016/j.jtcvs.2024.02.026 |
| PUBMED: | 38878052 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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