Limited resection trial for pulmonary groundglass opacity nodules: Case selection based on high-resolution computed tomography-Interim results

Junji Yoshida, Genichiro Ishii, Tomoyuki Hishida, Keiju Aokage, Masahiro Tsuboi, Hiroyuki Ito, Tomoyuki Yokose, Haruhiko Nakayama, Kouzo Yamada, Kanji Nagai

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: Our previous trial for small ground-glass opacity nodule on high-resolution computed tomography suggested all these cancers might have been radically managed with limited resection. Good correlation between radiologic and pathologic findings in early lung adenocarcinomas has been reported. We aimed to confirm limited resection efficacy as radical surgery in patients with high-resolution computed tomography-indicated minimally invasive lung cancer. The purpose of this interim analysis is to report the details of the patient and nodule characteristics, intraoperative cytology capability as a negative margin indicator, and patient outcome with the median follow-up period of 7 years and 4 months. Methods: Enrollment required patients with a tumor ≤2 cm, diagnosed or suspected as a cT1N0M0 carcinoma in the lung periphery and depicted on high-resolution computed tomography as a subsolid nodule with tumor disappearance ratio ≥0.5. We performed a wedge or segmental resection as appropriate. The primary endpoint is 10 year local recurrence-free survival rate. Results: This study started in November 2003, and 101 patients were enrolled as of November 2009. Of them, 95 were eligible for analysis. There were 38 men and 57 women, aged 30-75, averaging 62 years. Tumor sizes ranged from 7 to 20 mm on computed tomography, averaging 15 mm. Therewere 11 Noguchi type A tumors, 54 type B tumors, 24 type C tumors, one malignant lymphoma and 5 non-cancerous lesions. All cancers showed no vessel invasion.With a median follow-up period of 88 months, there have been no recurrences. Conclusion: So far, high-resolution computed tomography appears to predict non- or minimally invasive ground-glass opacity lung cancers with high reliability,warranting limited resection as curative surgery in this cohort.

Original languageEnglish
Pages (from-to)677-681
Number of pages5
JournalJapanese journal of clinical oncology
Volume45
Issue number7
DOIs
Publication statusPublished - 2015 Jan 1
Externally publishedYes

Keywords

  • Ground-glass opacity
  • High-resolution computed tomography
  • Limited resection
  • Lung cancer
  • Noguchi classification

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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