Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cstage IA non-small-cell lung cancer

Motoki Yano, Junji Yoshida, Terumoto Koike, Kotaro Kameyama, Akira Shimamoto, Wataru Nishio, Kentaro Yoshimoto, Tomoki Utsumi, Takayuki Shiina, Atsushi Watanabe, Yasushi Yamato, Takehiro Watanabe, Yusuke Takahashi, Makoto Sonobe, Hiroaki Kuroda, Makoto Oda, Masayoshi Inoue, Masayuki Tanahashi, Hirofumi Adachi, Masao Saito & 11 others Masataro Hayashi, Hajime Otsuka, Teruaki Mizobuchi, Yasumitsu Moriya, Mamoru Takahashi, Shigeto Nishikawa, Yuki Matsumura, Satoru Moriyama, Takeshi Nishiyama, Yoshitaka Fujii, Japanese Association for Chest Surgery

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVES: A precise preoperative diagnosis of 'very early' lung carcinoma may identify patients who can undergo curative surgery with limited resections. METHODS: Data from a multi-institutional project were collected on 1737 patients who had undergone limited resections (segmentectomy or wedge resection) for T1N0M0 non-small-cell carcinomas. As it was expected, this study was predominantly including ground glass nodules. Computed tomography was used to obtain the ratio of consolidation to the maximal tumour diameter to determine invasive potential of the tumours. Overall and disease-free survivals and recurrence-free proportions were analysed. RESULTS: Median age was 64 years. Mean maximal diameter of the tumours was 1.4 ± 0.5 cm. Overall and recurrence-free survivals after limited lung resection were 94.0 and 91.1% at 5 years, respectively. Recurrence-free proportions were 93.7% at 5 years. Unfavourable prognostic factors in overall survival were lymph node metastasis, interstitial pneumonia, male gender, older age, comorbidities (cardiac disease, diabetes etc.) and consolidation/tumour ratio (C/T) ≤ 0.25. C/T ≤ 0.25 predicted good outcomes especially in cT1aN0M0 disease. In a subclass analysis of cT1N0M0 squamous cell carcinomas, wedge resection was the only unfavourable prognostic factor in both overall and disease-free survivals. CONCLUSIONS: If the patient was 75 years old or younger and was judged fit for lobectomy, limited resection for cStage I non-small-cell lung cancer (NSCLC) showed excellent outcomes and was not inferior to the reported results of lobectomy for small-sized NSCLC. The carcinomas with C/T ≤ 0.25 rarely recur and are especially good candidates for limited resection.

Original languageEnglish
Article numberezu138
Pages (from-to)135-142
Number of pages8
JournalEuropean Journal of Cardio-thoracic Surgery
Volume47
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1
Externally publishedYes

Fingerprint

Non-Small Cell Lung Carcinoma
Survival
Neoplasms
Carcinoma
Recurrence
Disease-Free Survival
Lung
Segmental Mastectomy
Interstitial Lung Diseases
Glass
Comorbidity
Squamous Cell Carcinoma
Heart Diseases
Lymph Nodes
Tomography
Neoplasm Metastasis

Keywords

  • Limited resection
  • Lung cancer
  • Segmentectomy
  • Wedge resection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Yano, M., Yoshida, J., Koike, T., Kameyama, K., Shimamoto, A., Nishio, W., ... Japanese Association for Chest Surgery (2014). Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cstage IA non-small-cell lung cancer. European Journal of Cardio-thoracic Surgery, 47(1), 135-142. [ezu138]. https://doi.org/10.1093/ejcts/ezu138

Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cstage IA non-small-cell lung cancer. / Yano, Motoki; Yoshida, Junji; Koike, Terumoto; Kameyama, Kotaro; Shimamoto, Akira; Nishio, Wataru; Yoshimoto, Kentaro; Utsumi, Tomoki; Shiina, Takayuki; Watanabe, Atsushi; Yamato, Yasushi; Watanabe, Takehiro; Takahashi, Yusuke; Sonobe, Makoto; Kuroda, Hiroaki; Oda, Makoto; Inoue, Masayoshi; Tanahashi, Masayuki; Adachi, Hirofumi; Saito, Masao; Hayashi, Masataro; Otsuka, Hajime; Mizobuchi, Teruaki; Moriya, Yasumitsu; Takahashi, Mamoru; Nishikawa, Shigeto; Matsumura, Yuki; Moriyama, Satoru; Nishiyama, Takeshi; Fujii, Yoshitaka; Japanese Association for Chest Surgery.

In: European Journal of Cardio-thoracic Surgery, Vol. 47, No. 1, ezu138, 01.01.2014, p. 135-142.

Research output: Contribution to journalArticle

Yano, M, Yoshida, J, Koike, T, Kameyama, K, Shimamoto, A, Nishio, W, Yoshimoto, K, Utsumi, T, Shiina, T, Watanabe, A, Yamato, Y, Watanabe, T, Takahashi, Y, Sonobe, M, Kuroda, H, Oda, M, Inoue, M, Tanahashi, M, Adachi, H, Saito, M, Hayashi, M, Otsuka, H, Mizobuchi, T, Moriya, Y, Takahashi, M, Nishikawa, S, Matsumura, Y, Moriyama, S, Nishiyama, T, Fujii, Y & Japanese Association for Chest Surgery 2014, 'Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cstage IA non-small-cell lung cancer', European Journal of Cardio-thoracic Surgery, vol. 47, no. 1, ezu138, pp. 135-142. https://doi.org/10.1093/ejcts/ezu138
Yano, Motoki ; Yoshida, Junji ; Koike, Terumoto ; Kameyama, Kotaro ; Shimamoto, Akira ; Nishio, Wataru ; Yoshimoto, Kentaro ; Utsumi, Tomoki ; Shiina, Takayuki ; Watanabe, Atsushi ; Yamato, Yasushi ; Watanabe, Takehiro ; Takahashi, Yusuke ; Sonobe, Makoto ; Kuroda, Hiroaki ; Oda, Makoto ; Inoue, Masayoshi ; Tanahashi, Masayuki ; Adachi, Hirofumi ; Saito, Masao ; Hayashi, Masataro ; Otsuka, Hajime ; Mizobuchi, Teruaki ; Moriya, Yasumitsu ; Takahashi, Mamoru ; Nishikawa, Shigeto ; Matsumura, Yuki ; Moriyama, Satoru ; Nishiyama, Takeshi ; Fujii, Yoshitaka ; Japanese Association for Chest Surgery. / Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cstage IA non-small-cell lung cancer. In: European Journal of Cardio-thoracic Surgery. 2014 ; Vol. 47, No. 1. pp. 135-142.
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abstract = "OBJECTIVES: A precise preoperative diagnosis of 'very early' lung carcinoma may identify patients who can undergo curative surgery with limited resections. METHODS: Data from a multi-institutional project were collected on 1737 patients who had undergone limited resections (segmentectomy or wedge resection) for T1N0M0 non-small-cell carcinomas. As it was expected, this study was predominantly including ground glass nodules. Computed tomography was used to obtain the ratio of consolidation to the maximal tumour diameter to determine invasive potential of the tumours. Overall and disease-free survivals and recurrence-free proportions were analysed. RESULTS: Median age was 64 years. Mean maximal diameter of the tumours was 1.4 ± 0.5 cm. Overall and recurrence-free survivals after limited lung resection were 94.0 and 91.1{\%} at 5 years, respectively. Recurrence-free proportions were 93.7{\%} at 5 years. Unfavourable prognostic factors in overall survival were lymph node metastasis, interstitial pneumonia, male gender, older age, comorbidities (cardiac disease, diabetes etc.) and consolidation/tumour ratio (C/T) ≤ 0.25. C/T ≤ 0.25 predicted good outcomes especially in cT1aN0M0 disease. In a subclass analysis of cT1N0M0 squamous cell carcinomas, wedge resection was the only unfavourable prognostic factor in both overall and disease-free survivals. CONCLUSIONS: If the patient was 75 years old or younger and was judged fit for lobectomy, limited resection for cStage I non-small-cell lung cancer (NSCLC) showed excellent outcomes and was not inferior to the reported results of lobectomy for small-sized NSCLC. The carcinomas with C/T ≤ 0.25 rarely recur and are especially good candidates for limited resection.",
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AU - Yano, Motoki

AU - Yoshida, Junji

AU - Koike, Terumoto

AU - Kameyama, Kotaro

AU - Shimamoto, Akira

AU - Nishio, Wataru

AU - Yoshimoto, Kentaro

AU - Utsumi, Tomoki

AU - Shiina, Takayuki

AU - Watanabe, Atsushi

AU - Yamato, Yasushi

AU - Watanabe, Takehiro

AU - Takahashi, Yusuke

AU - Sonobe, Makoto

AU - Kuroda, Hiroaki

AU - Oda, Makoto

AU - Inoue, Masayoshi

AU - Tanahashi, Masayuki

AU - Adachi, Hirofumi

AU - Saito, Masao

AU - Hayashi, Masataro

AU - Otsuka, Hajime

AU - Mizobuchi, Teruaki

AU - Moriya, Yasumitsu

AU - Takahashi, Mamoru

AU - Nishikawa, Shigeto

AU - Matsumura, Yuki

AU - Moriyama, Satoru

AU - Nishiyama, Takeshi

AU - Fujii, Yoshitaka

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N2 - OBJECTIVES: A precise preoperative diagnosis of 'very early' lung carcinoma may identify patients who can undergo curative surgery with limited resections. METHODS: Data from a multi-institutional project were collected on 1737 patients who had undergone limited resections (segmentectomy or wedge resection) for T1N0M0 non-small-cell carcinomas. As it was expected, this study was predominantly including ground glass nodules. Computed tomography was used to obtain the ratio of consolidation to the maximal tumour diameter to determine invasive potential of the tumours. Overall and disease-free survivals and recurrence-free proportions were analysed. RESULTS: Median age was 64 years. Mean maximal diameter of the tumours was 1.4 ± 0.5 cm. Overall and recurrence-free survivals after limited lung resection were 94.0 and 91.1% at 5 years, respectively. Recurrence-free proportions were 93.7% at 5 years. Unfavourable prognostic factors in overall survival were lymph node metastasis, interstitial pneumonia, male gender, older age, comorbidities (cardiac disease, diabetes etc.) and consolidation/tumour ratio (C/T) ≤ 0.25. C/T ≤ 0.25 predicted good outcomes especially in cT1aN0M0 disease. In a subclass analysis of cT1N0M0 squamous cell carcinomas, wedge resection was the only unfavourable prognostic factor in both overall and disease-free survivals. CONCLUSIONS: If the patient was 75 years old or younger and was judged fit for lobectomy, limited resection for cStage I non-small-cell lung cancer (NSCLC) showed excellent outcomes and was not inferior to the reported results of lobectomy for small-sized NSCLC. The carcinomas with C/T ≤ 0.25 rarely recur and are especially good candidates for limited resection.

AB - OBJECTIVES: A precise preoperative diagnosis of 'very early' lung carcinoma may identify patients who can undergo curative surgery with limited resections. METHODS: Data from a multi-institutional project were collected on 1737 patients who had undergone limited resections (segmentectomy or wedge resection) for T1N0M0 non-small-cell carcinomas. As it was expected, this study was predominantly including ground glass nodules. Computed tomography was used to obtain the ratio of consolidation to the maximal tumour diameter to determine invasive potential of the tumours. Overall and disease-free survivals and recurrence-free proportions were analysed. RESULTS: Median age was 64 years. Mean maximal diameter of the tumours was 1.4 ± 0.5 cm. Overall and recurrence-free survivals after limited lung resection were 94.0 and 91.1% at 5 years, respectively. Recurrence-free proportions were 93.7% at 5 years. Unfavourable prognostic factors in overall survival were lymph node metastasis, interstitial pneumonia, male gender, older age, comorbidities (cardiac disease, diabetes etc.) and consolidation/tumour ratio (C/T) ≤ 0.25. C/T ≤ 0.25 predicted good outcomes especially in cT1aN0M0 disease. In a subclass analysis of cT1N0M0 squamous cell carcinomas, wedge resection was the only unfavourable prognostic factor in both overall and disease-free survivals. CONCLUSIONS: If the patient was 75 years old or younger and was judged fit for lobectomy, limited resection for cStage I non-small-cell lung cancer (NSCLC) showed excellent outcomes and was not inferior to the reported results of lobectomy for small-sized NSCLC. The carcinomas with C/T ≤ 0.25 rarely recur and are especially good candidates for limited resection.

KW - Limited resection

KW - Lung cancer

KW - Segmentectomy

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