The impact of residual tumor morphology on prognosis, recurrence, and fistula formation after lung cancer resection

Takeshi Kawaguchi, Shun Ichi Watanabe, Riken Kawachi, Kenji Suzuki, Hisao Asamura

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

INTRODUCTION: The prognosis and proper management of patients with microscopic residual tumor at the bronchial resection margins (bronchial R1) remain unclear. METHODS: We performed a retrospective analysis of 74 patients who underwent pulmonary resection for lung cancer between 1976 and 2003 and had bronchial R1. The prognosis, pattern of the recurrence, and occurrence of the bronchopleural fistula (BPF) were analyzed according to the types of bronchial R1 morphology: direct extension (DIR, n = 11), peribronchial extension (PER, n = 54), and carcinoma in situ (CIS, n = 9). RESULTS: Five-year survival rates of patients with DIR, PER, and CIS were 0, 10, and 63%, respectively. The patients with CIS showed significantly better prognosis than those with DIR and PER (p = 0.0006, p = 0.0009, respectively). No prognostic difference was observed between patients with DIR and PER (p = 0.1753). Recurrent disease developed in 43 patients (58%). Only one of nine patients with CIS (11%) had recurrence, whereas 6 of 11 patients with DIR (55%) and 36 of 54 patients with PER (67%) had disease relapse. The recurrence rate in the CIS group was significantly lower than those of the other two groups (CIS versus DIR, p = 0.036; CIS versus PER, p = 0.006, respectively). BPF formation was not detected in patients with CIS; however, BPF developed in 3 of 11 patients with DIR (27%) and 3 of 54 patients with PER (5.6%). CONCLUSIONS: Residual tumor morphology influenced the prognosis of patients with postresection bronchial R1 disease.

Original languageEnglish
Pages (from-to)599-603
Number of pages5
JournalJournal of Thoracic Oncology
Volume3
Issue number6
DOIs
Publication statusPublished - 2008 Jun
Externally publishedYes

Keywords

  • Bronchial R1
  • Bronchopleural fistula
  • Lung resection
  • Non-small cell lung cancer

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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