Yasuhiro Tsutani1, Yoshihiro Miyata1, Haruhiko Nakayama2, Sakae Okumura3, Shuji Adachi4, Masahiro Yoshimura5, Morihito Okada6. 1. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan. 2. Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan. 3. Department of Thoracic Surgery, Cancer Institute Hospital, Tokyo, Japan. 4. Department of Radiology, Hyogo Cancer Center, Akashi, Japan. 5. Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan. 6. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan morihito@hiroshima-u.ac.jp.
Abstract
OBJECTIVES: This study aimed to compare prognosis after segmentectomy and after lobectomy for radiologically determined solid-dominant clinical stage IA lung adenocarcinoma. METHODS: From a multicentre database of 610 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection after preoperative high-resolution computed tomography (HRCT) and F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), 327 patients with a radiologically determined solid-dominant tumour (solid component on HRCT ≥50%) who underwent lobectomy (n = 286) or segmentectomy (n = 41) were included. RESULTS: No significant difference existed in recurrence-free survival (RFS) between the lobectomy and segmentectomy groups (3-year RFS, 84.4 vs 84.8%, respectively; P = 0.69). There was no significant difference in recurrence pattern between these two groups (local, 5.6 vs 7.3%, P = 0.72; distant, 9.1 vs 4.9%, P = 0.55, respectively). Even in patients with pure solid tumours, no significant difference was observed in RFS between lobectomy and segmentectomy groups (3-year RFS, 76.8 vs 84.7%, respectively; P = 0.48), as well as in those with a mixed ground-glass opacity tumour (3-year RFS, 91.0 vs 85.0%, respectively; P = 0.60). Multivariate Cox analysis demonstrated that solid tumour size on HRCT (P = 0.048) and maximum standardized uptake value (SUVmax) on FDG-PET/CT (P < 0.001), not the surgical procedure (P = 0.40), were independent prognostic factors for RFS. CONCLUSIONS: RFS depends on solid tumour size on HRCT and SUVmax on FDG-PET/CT, rather than on the surgical procedure, in patients with radiologically detected solid-dominant clinical stage IA lung adenocarcinoma. Patient prognosis is similar after lobectomy and after segmentectomy for solid-dominant tumour.
OBJECTIVES: This study aimed to compare prognosis after segmentectomy and after lobectomy for radiologically determined solid-dominant clinical stage IA lung adenocarcinoma. METHODS: From a multicentre database of 610 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection after preoperative high-resolution computed tomography (HRCT) and F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), 327 patients with a radiologically determined solid-dominant tumour (solid component on HRCT ≥50%) who underwent lobectomy (n = 286) or segmentectomy (n = 41) were included. RESULTS: No significant difference existed in recurrence-free survival (RFS) between the lobectomy and segmentectomy groups (3-year RFS, 84.4 vs 84.8%, respectively; P = 0.69). There was no significant difference in recurrence pattern between these two groups (local, 5.6 vs 7.3%, P = 0.72; distant, 9.1 vs 4.9%, P = 0.55, respectively). Even in patients with pure solid tumours, no significant difference was observed in RFS between lobectomy and segmentectomy groups (3-year RFS, 76.8 vs 84.7%, respectively; P = 0.48), as well as in those with a mixed ground-glass opacity tumour (3-year RFS, 91.0 vs 85.0%, respectively; P = 0.60). Multivariate Cox analysis demonstrated that solid tumour size on HRCT (P = 0.048) and maximum standardized uptake value (SUVmax) on FDG-PET/CT (P < 0.001), not the surgical procedure (P = 0.40), were independent prognostic factors for RFS. CONCLUSIONS: RFS depends on solid tumour size on HRCT and SUVmax on FDG-PET/CT, rather than on the surgical procedure, in patients with radiologically detected solid-dominant clinical stage IA lung adenocarcinoma. Patient prognosis is similar after lobectomy and after segmentectomy for solid-dominant tumour.
Authors: So Hee Song; Joong Hyun Ahn; Ho Yun Lee; Geewon Lee; Joon Young Choi; Jun Kang; Eun Young Kim; Joungho Han; O Jung Kwon; Kyung Soo Lee; Hong Kwan Kim; Yong Soo Choi; Jhingook Kim; Young Mog Shim Journal: Eur Radiol Date: 2015-10-11 Impact factor: 5.315