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 language | English |
|---|---|
| Article number | ezu138 |
| Pages (from-to) | 135-142 |
| Number of pages | 8 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 47 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 Jan 1 |
| Externally published | Yes |
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Keywords
- Limited resection
- Lung cancer
- Segmentectomy
- Wedge resection
ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cstage IA non-small-cell lung cancer
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
AU - Japanese Association for Chest Surgery
PY - 2014/1/1
Y1 - 2014/1/1
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
KW - Wedge resection
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U2 - 10.1093/ejcts/ezu138
DO - 10.1093/ejcts/ezu138
M3 - Article
VL - 47
SP - 135
EP - 142
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 1
M1 - ezu138
ER -