TY - JOUR
T1 - Long-term outcomes of 50 cases of limited-resection trial for pulmonary ground-glass opacity nodules
AU - Nakao, Masayuki
AU - Yoshida, Junji
AU - Goto, Koichi
AU - Ishii, Genichiro
AU - Kawase, Akikazu
AU - Aokage, Keiju
AU - Hishida, Tomoyuki
AU - Nishimura, Mitsuyo
AU - Nagai, Kanji
N1 - Funding Information:
The authors thank Mr. Roderick J. Turner and Professor J. Patrick Barron, chairman of the Department of International Medical Communications of Tokyo Medical University for their editorial review of this article. The work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare, Japan.
PY - 2012/10
Y1 - 2012/10
N2 - Introduction: From 1998 to 2002, we performed a trial of prospective limited resection for pulmonary ground-glass opacity lesions 2 cm or smaller. This is the second report on the long-term outcome. Methods: The enrollment criteria of the trial were as follows: pulmonary peripheral nodule less than 2 cm, diagnosis or suspected diagnosis of clinical T1N0M0 carcinoma with ground-glass opacity and lack of evident pleural indentations or vascular convergence on high-resolution computed tomography. Limited-resection (wedge or segment) specimens were intraoperatively examined by frozen section. If the nodule was confirmed as Noguchi type A or B with a resection margin of greater than 1 cm, the incision was sutured and the patient followed up. The median surveillance period was 10 years. Results: In a total of 50 enrolled participants, there were two Noguchi type A, 23 type B and 15 type C adenocarcinomas; five atypical adenomatous hyperplasias, four fibroses, and one granuloma. Although there were no patients with recurrence within the first 5 years, in four patients who underwent limited-resection pulmonary adenocarcinoma developed more than 5 years after the initial resection, of either cut-end recurrence or metachronous primary disease. Conclusions: Of 26 patients who underwent limited resection, adenocarcinoma developed in four after more than 5 years. These were possibly cut-end recurrences. We concluded that 5 years is not a sufficient period for follow-up, and that limited resection should still be done only in a trial setting, even for small ground-glass opacity lesions.
AB - Introduction: From 1998 to 2002, we performed a trial of prospective limited resection for pulmonary ground-glass opacity lesions 2 cm or smaller. This is the second report on the long-term outcome. Methods: The enrollment criteria of the trial were as follows: pulmonary peripheral nodule less than 2 cm, diagnosis or suspected diagnosis of clinical T1N0M0 carcinoma with ground-glass opacity and lack of evident pleural indentations or vascular convergence on high-resolution computed tomography. Limited-resection (wedge or segment) specimens were intraoperatively examined by frozen section. If the nodule was confirmed as Noguchi type A or B with a resection margin of greater than 1 cm, the incision was sutured and the patient followed up. The median surveillance period was 10 years. Results: In a total of 50 enrolled participants, there were two Noguchi type A, 23 type B and 15 type C adenocarcinomas; five atypical adenomatous hyperplasias, four fibroses, and one granuloma. Although there were no patients with recurrence within the first 5 years, in four patients who underwent limited-resection pulmonary adenocarcinoma developed more than 5 years after the initial resection, of either cut-end recurrence or metachronous primary disease. Conclusions: Of 26 patients who underwent limited resection, adenocarcinoma developed in four after more than 5 years. These were possibly cut-end recurrences. We concluded that 5 years is not a sufficient period for follow-up, and that limited resection should still be done only in a trial setting, even for small ground-glass opacity lesions.
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U2 - 10.1097/JTO.0b013e3182641b5c
DO - 10.1097/JTO.0b013e3182641b5c
M3 - Article
C2 - 22878750
AN - SCOPUS:84866615721
VL - 7
SP - 1563
EP - 1566
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
IS - 10
ER -