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AATS and Leading Cancer Center’s Thoracic Surgery Oncology Group (TSOG) Complete First Clinical Trial Involving Ground Glass Lung Nodules Identified on CT Scan

The American Association for Thoracic Surgery (AATS) and Memorial Sloan Kettering Cancer Center’s (MSK) Thoracic Surgery Oncology Group (TSOG) completed its first clinical trial involving 330 patients who have ground glass lung nodules identified on a CT scan.

In this study, these nodules undergo active surveillance with CT scan imaging for five years to determine if these lesions become cancer. At the completion of this trial, TSOG hopes to better identify which patients with these ground glass nodules require surgery and which could forgo surgery and be managed with active radiographic surveillance. Patients will be monitored with chest CT scan biannually or annually per standard of care or based on the treating clinicians’ discretion for up to 5 years. The primary objective of this study is to determine lung cancer–specific survival at 5 years in patients undergoing active surveillance for GGOs. The secondary objective is to determine the following endpoints among patients undergoing active surveillance for GGOs: overall survival, freedom from progression (any), freedom from nodal progression, freedom from distant progression, cumulative incidence of intervention (biopsy or resection), cumulative incidence of a new GGO, and cumulative incidence of confirmed lung cancer diagnosis. We expect our interim analysis within the next two years and the final report after all patients have been followed for 5 years.

“TSOG will continue to increase membership and I expect that we will increase the number and types of clinical trials in our portfolio,” said David R. Jones, MD, Chair of TSOG and Professor & Chief of Thoracic Surgery at MSK. “Given the robust network of TSOG sites and the increasing appreciation of the importance of thoracic surgeon participation in multidisciplinary treatment plans, TSOG will be actively involved in industry-sponsored clinical trials involving targeted therapies, immunotherapy, and other therapies combined with surgery and/or radiation. We also plan to expand the TSOG portfolio of trials to further include patient reported outcome studies, and, when possible, medical device utilization and application.”

There are five additional clinical trials open in TSOG. These include registry studies, trials examining the role of ctDNA in patients receiving neoadjuvant therapy for lung cancer, discovery of new biomarkers for mesothelioma, and patient reported outcomes and outcomes in patients who receive surgery or stereotactic radiation for lung cancer. Most of these are investigator-initiated clinical trials and several are supported by federal grants.

Several presentations about the ongoing TSOG trials will take place at the AATS International Thoracic Surgical Oncology Summit, September 22-23, in New York.

TSOG was established in 2017 as a joint venture between AATS and MSK to integrate thoracic surgeons into clinical trials for patients who receive surgery as part of their care plan for lung, esophageal cancers and mesothelioma and other tumors of the chest cavity. These clinical trials will assist in defining care standards that will support future patients and their families who have these diseases.

There are 29 member institutions within TSOG. The institutions are in North America with 3 of the 29 sites in Canada. There is growing interest in expanding TSOG to collaborate with other institutions in Europe.


The American Association for Thoracic Surgery (AATS) is an international organization that encourages, promotes, and stimulates the scientific investigation of cardiothoracic surgery. Founded in 1917 by a respected group of the earliest pioneers in the field, its original mission was to “foster the evolution of an interest in surgery of the Thorax.” Today, the AATS is the premier association for cardiothoracic surgeons in the world and works to continually enhance the ability of cardiothoracic surgeons to provide the highest quality of patient care. Its more than 1,500 members have a proven record of distinction within the specialty and have made significant contributions to the care and treatment of cardiothoracic disease. Visit to learn more.