The June 24, 2013 issue of Annals of Thoracic Surgery (AnnThoracSurg) published the results of a new study on the increasing number of invasive lung adenocarcinomas with concurrent, multifocal, ground glass shadows of in situ lesions (GGOs) currently found. The optimal regimen in such cases (often in nonsmokers) remains unclear. In the absence of a uniformly definitive opinion on whether a single adenocarcinoma with multiple ground glass nodules indicates advanced disease, Dr. Shrager et al. from the Department of Thoracic Surgery, Stanford University School of Medicine, conducted a study and published their results. The authors found a good prognosis for patients with anatomically resected major tumors (DT) and wedge resection of ipsilateral operable GGOs, for which patients should not be considered occult T4 or M1a. The study retrospectively analyzed 39 cases of suspected multifocal adenocarcinoma in situ and 1 major tumor (DT) in a predominantly white population. The mean follow-up was 30.7 months. The authors performed a statistical analysis of the general clinical data, the nature of the main lesion, the surgical approach, the time to multiplication of residual ground glass nodules and the postoperative survival time in this group of patients. The results of the study showed that 49% of the patients had no or little smoking and 21% were Asian. The DT resected were pathologically confirmed as “fine bronchoalveolar carcinoma” (26%), microinvasive adenocarcinoma (5%), adenocarcinoma with fine bronchoalveolar differentiation (41%) and well-differentiated adenocarcinoma (28%). pT staging of DT was stage IA in 20 cases, stage IB in 15 cases and stage IIA in 4 cases, with a mean diameter of 2.6 cm. 32 cases (82%) underwent anatomic resection of DT and 7 cases (18%) underwent wedge resection. ) underwent wedge resection. The mean number of initial GGOs was 2.7 (range 1?7) and the mean diameter was 5.2 mm. only 9 patients (23%) had unresected nodes that increased in size during the follow-up period. The mean diameter of growth was 3.2 mm and the mean doubling time was 49 months. 16 patients (41%) had new GGOs (range 1 to 8), and all nodes were mostly below 7 mm. There were 2 cases (5.2%) of distant metastases; only 1 patient required intervention for progressive GGOs. The overall survival rate was 100%. This study found that patients with limited, multifocal adenocarcinoma in situ and clinical N0DT with dissecting resection of DTs and wedge resection of operable GGOs contributed to prolonged survival. These patients should not be considered to have occult T4 or M1a.