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Chest. 2014 Jan;145(1):66-71. doi: 10.1378/chest.13-1094.

Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage IA lung adenocarcinoma: wedge resection or segmentectomy.

Author information

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.

Comment in

PMID:
24551879
DOI:
10.1378/chest.13-1094
[Indexed for MEDLINE]

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