TY - JOUR
T1 - The impact of residual tumor morphology on prognosis, recurrence, and fistula formation after lung cancer resection
AU - Kawaguchi, Takeshi
AU - Watanabe, Shun Ichi
AU - Kawachi, Riken
AU - Suzuki, Kenji
AU - Asamura, Hisao
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2008/6
Y1 - 2008/6
N2 - 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.
AB - 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.
KW - Bronchial R1
KW - Bronchopleural fistula
KW - Lung resection
KW - Non-small cell lung cancer
UR - http://www.scopus.com/inward/record.url?scp=44649183365&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=44649183365&partnerID=8YFLogxK
U2 - 10.1097/JTO.0b013e3181753b70
DO - 10.1097/JTO.0b013e3181753b70
M3 - Article
C2 - 18520797
AN - SCOPUS:44649183365
VL - 3
SP - 599
EP - 603
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
IS - 6
ER -