Long-term outcomes of 50 cases of limited-resection trial for pulmonary ground-glass opacity nodules

Masayuki Nakao, Junji Yoshida, Koichi Goto, Genichiro Ishii, Akikazu Kawase, Keiju Aokage, Tomoyuki Hishida, Mitsuyo Nishimura, Kanji Nagai

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57 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1563-1566
Number of pages4
JournalJournal of Thoracic Oncology
Volume7
Issue number10
DOIs
Publication statusPublished - 2012 Oct
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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    Nakao, M., Yoshida, J., Goto, K., Ishii, G., Kawase, A., Aokage, K., Hishida, T., Nishimura, M., & Nagai, K. (2012). Long-term outcomes of 50 cases of limited-resection trial for pulmonary ground-glass opacity nodules. Journal of Thoracic Oncology, 7(10), 1563-1566. https://doi.org/10.1097/JTO.0b013e3182641b5c