Yasuhiro Tsutani1, Yoshihiro Miyata1, Haruhiko Nakayama2, Sakae Okumura3, Shuji Adachi4, Masahiro Yoshimura5, Morihito Okada6. 1. Department of Surgical Oncology, Hiroshima University, Hiroshima. 2. Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama. 3. Department of Thoracic Surgery, Cancer Institute Hospital, Tokyo. 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. Electronic address: morihito@hiroshima-u.ac.jp.
Abstract
BACKGROUND: The purpose of this multicenter study was to characterize ground glass opacity (GGO)-dominant clinical stage IA lung adenocarcinomas and evaluate prognosis of these tumors after sublobar resection, such as segmentectomy and wedge resection. METHODS: We evaluated 610 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection after preoperative high-resolution CT scanning and 18 F-fl uorodeoxyglucose PET/CT scanning and revealed 239 (39.2%) that had a . 50% GGO component. RESULTS: GGO-dominant tumors rarely exhibited pathologic invasiveness, including lymphatic, vascular, or pleural invasion and lymph node metastasis. There was no significant difference in 3-year recurrence-free survival (RFS) among patients who underwent lobectomy (96.4%), segmentectomy (96.1%), and wedge resection (98.7%) of GGO-dominant tumors ( P = .44). Furthermore, for GGO-dominant T1b tumors, 3-year RFS was similar in patients who underwent lobectomy (93.7%), segmentectomy (92.9%), and wedge resection (100%, P = .66). Two of 84 patients (2.4%) with GGO-dominant T1b tumors had lymph node metastasis. Multivariate Cox analysis showed that tumor size, maximum standardized uptake value on 18 F-fl uorodeoxyglucose PET/CT scan, and surgical procedure did not affect RFS in GGO-dominant tumors. CONCLUSIONS: GGO-dominant clinical stage IA lung adenocarcinomas are a uniform group of tumors that exhibit low-grade malignancy and have an extremely favorable prognosis. Patients with GGOdominant clinical stage IA adenocarcinomas can be successfully treated with wedge resection of a T1a tumor and segmentectomy of a T1b tumor.
BACKGROUND: The purpose of this multicenter study was to characterize ground glass opacity (GGO)-dominant clinical stage IA lung adenocarcinomas and evaluate prognosis of these tumors after sublobar resection, such as segmentectomy and wedge resection. METHODS: We evaluated 610 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection after preoperative high-resolution CT scanning and 18 F-fl uorodeoxyglucose PET/CT scanning and revealed 239 (39.2%) that had a . 50% GGO component. RESULTS:GGO-dominant tumors rarely exhibited pathologic invasiveness, including lymphatic, vascular, or pleural invasion and lymph node metastasis. There was no significant difference in 3-year recurrence-free survival (RFS) among patients who underwent lobectomy (96.4%), segmentectomy (96.1%), and wedge resection (98.7%) of GGO-dominant tumors ( P = .44). Furthermore, for GGO-dominant T1b tumors, 3-year RFS was similar in patients who underwent lobectomy (93.7%), segmentectomy (92.9%), and wedge resection (100%, P = .66). Two of 84 patients (2.4%) with GGO-dominant T1b tumors had lymph node metastasis. Multivariate Cox analysis showed that tumor size, maximum standardized uptake value on 18 F-fl uorodeoxyglucose PET/CT scan, and surgical procedure did not affect RFS in GGO-dominant tumors. CONCLUSIONS:GGO-dominant clinical stage IA lung adenocarcinomas are a uniform group of tumors that exhibit low-grade malignancy and have an extremely favorable prognosis. Patients with GGOdominant clinical stage IA adenocarcinomas can be successfully treated with wedge resection of a T1a tumor and segmentectomy of a T1b tumor.
Authors: Morgan L Cox; Chi-Fu Jeffrey Yang; Paul J Speicher; Kevin L Anderson; Zachary W Fitch; Lin Gu; Robert Patrick Davis; Xiaofei Wang; Thomas A D'Amico; Matthew G Hartwig; David H Harpole; Mark F Berry Journal: J Thorac Oncol Date: 2017-01-08 Impact factor: 15.609
Authors: Sang Min Lee; Jin Mo Goo; Kyung Hee Lee; Doo Hyun Chung; Jaemoon Koh; Chang Min Park Journal: Eur Radiol Date: 2015-02-14 Impact factor: 5.315
Authors: Yun-Yan Ren; You-Cai Li; Hu-Bing Wu; Quan-Shi Wang; Yan-Jiang Han; Wen-Lan Zhou; Hong-Sheng Li; Zhen Wang; Mohammed Shah Alam Mohammed Shah Alam Journal: Nan Fang Yi Ke Da Xue Xue Bao Date: 2017-03-20
Authors: Christopher Cao; David H Tian; Ben Fu; James Huang; Neel K Ranganath; Dominique Gossot Journal: J Thorac Dis Date: 2018-09 Impact factor: 2.895