Aritoshi Hattori1, Takeshi Matsunaga1, Kazuya Takamochi1, Shiaki Oh1, Kenji Suzuki2. 1. Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan. 2. Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan. kjsuzuki@juntendo.ac.jp.
Abstract
PURPOSE: We investigated the surgical outcomes of clinical-T1b lung adenocarcinomas patients whose tumors had a solid-dominant radiological appearance and who were treated with segmentectomy or lobectomy. METHODS: We examined 154 surgically resected clinical-T1b lung adenocarcinomas with a "solid-dominant" appearance on thin-section computed tomography (CT). The preoperative thin-section CT images of all cases were reviewed. "Solid-dominant" was defined as 0.5≤ consolidation/tumor ratio (CTR) <1.0. RESULTS: Pathological nodal metastasis, lymphatic invasion, vascular invasion, and pleural invasion were found in 7 (4.5 %), 27 (18 %), 21 (14 %), and 15 (10 %) patients with clinical-T1b solid-dominant lung adenocarcinoma, respectively. Lobectomy and segmentectomy were performed in 123 (80 %) and 31 (20 %) cases, respectively. The 3-year overall survival (OS) and relapse-free survival (RFS) of patients with clinical-T1b solid-dominant lung adenocarcinoma were 95.5 and 92.4 %, respectively. The 3-year RFS and OS did not differ significantly between the patients who underwent lobectomy or segmentectomy (3-year RFS, 92.3 vs. 93.4 %, p = 0.8713; 3-year OS, 95.3 vs. 96.6 %, p = 0.7603). Segmentectomy was not found to be a prognostic factor for RFS (p = 0.8714), or OS (p = 0.7613). CONCLUSIONS: Segmentectomy can achieve acceptable oncological outcomes (both in terms of OS and RFS), which are similar to those achieved with standard lobectomy, in patients with clinical-T1b solid-dominant lung adenocarcinoma.
PURPOSE: We investigated the surgical outcomes of clinical-T1b lung adenocarcinomaspatients whose tumors had a solid-dominant radiological appearance and who were treated with segmentectomy or lobectomy. METHODS: We examined 154 surgically resected clinical-T1b lung adenocarcinomas with a "solid-dominant" appearance on thin-section computed tomography (CT). The preoperative thin-section CT images of all cases were reviewed. "Solid-dominant" was defined as 0.5≤ consolidation/tumor ratio (CTR) <1.0. RESULTS: Pathological nodal metastasis, lymphatic invasion, vascular invasion, and pleural invasion were found in 7 (4.5 %), 27 (18 %), 21 (14 %), and 15 (10 %) patients with clinical-T1b solid-dominant lung adenocarcinoma, respectively. Lobectomy and segmentectomy were performed in 123 (80 %) and 31 (20 %) cases, respectively. The 3-year overall survival (OS) and relapse-free survival (RFS) of patients with clinical-T1b solid-dominant lung adenocarcinoma were 95.5 and 92.4 %, respectively. The 3-year RFS and OS did not differ significantly between the patients who underwent lobectomy or segmentectomy (3-year RFS, 92.3 vs. 93.4 %, p = 0.8713; 3-year OS, 95.3 vs. 96.6 %, p = 0.7603). Segmentectomy was not found to be a prognostic factor for RFS (p = 0.8714), or OS (p = 0.7613). CONCLUSIONS: Segmentectomy can achieve acceptable oncological outcomes (both in terms of OS and RFS), which are similar to those achieved with standard lobectomy, in patients with clinical-T1b solid-dominant lung adenocarcinoma.
Authors: Gail E Darling; Mark S Allen; Paul A Decker; Karla Ballman; Richard A Malthaner; Richard I Inculet; David R Jones; Robert J McKenna; Rodney J Landreneau; Valerie W Rusch; Joe B Putnam Journal: J Thorac Cardiovasc Surg Date: 2011-03 Impact factor: 5.209
Authors: Robert J Keenan; Rodney J Landreneau; Richard H Maley; Deepak Singh; Robin Macherey; Susan Bartley; Tibetha Santucci Journal: Ann Thorac Surg Date: 2004-07 Impact factor: 4.330