[Expert Consensus on Shared Decision-making in the Diagnosis and Treatment of Ground-glass Opacity-featured Lung Adenocarcinoma].

Abstract

With the popularization of low-dose computed tomography (LDCT) screening, the detection rate of ground-glass opacity (GGO) has been continuously increasing. Ground-glass opacity-featured lung adenocarcinoma is mostly characterized by indolent biological behavior and favorable prognosis. However, its progression is uncertain and recommendations vary among guidelines. This places clinicians in a dilemma between timely intervention and avoiding overdiagnosis and overtreatment, while patients often suffer from follow-up anxiety and decision-making confusion. To standardize the whole-process management on an evidence-based basis and fully incorporate patient values, this expert consensus systematically reviews the entire procedure of GGO diagnosis and treatment, establishes shared decision-making between doctors and patients as the core principle, and emphasizes formulating management strategies by integrating patient values, life goals and risk preferences. The consensus covers key components including the starting and ending ages for screening, limitations of imaging diagnosis and indications for invasive diagnosis, indications and timing of surgery, strategies for sublobar resection and lymph node management, management of multiple GGOs, non-surgical alternative therapies, reliability of intraoperative frozen-section pathology, postoperative enhanced recovery and pain management, eligible populations for adjuvant therapy, and follow-up strategies. By promoting multidisciplinary collaboration and structured communication, this consensus aims to facilitate the transformation of the diagnosis and treatment model from disease-centered to patient value-centered, improve medical quality and patient satisfaction, reduce overtreatment, and promote doctor-patient harmony.
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