Outcome of Resected Lung Cancers with Subcentimeter Solid Component on Computed Tomography.


Journal

The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387

Informations de publication

Date de publication:
04 2023
Historique:
medline: 7 4 2023
pubmed: 3 11 2022
entrez: 2 11 2022
Statut: ppublish

Résumé

Although the opportunity to treat subcentimeter lung cancers has increased, the optimal surgical methods remain unclear. We performed a retrospective study to examine the clinical outcome of subcentimeter lung cancers. In total, 118 patients who underwent curative resection for subcentimeter lung cancer from January 2005 to December 2013 were analyzed. Multivariate Cox proportional hazards models were used to calculate the hazard ratio to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS). Anatomical resections were performed for 64 patients (59 lobectomies and 5 segmentectomies) and wedge resections for 54 patients. Recurrence developed in six patients who had consolidation-predominant tumors (consolidation/tumor [C/T] ratio of >0.5) and underwent wedge resections. The first recurrence patterns were regional recurrences in three patients, both regional and distant in one, and distant in two. Seventeen patients died of other causes. The multivariate analysis revealed that the C/T ratio was the independent predictor of RFS ( Patients with subcentimeter lung cancer rarely developed recurrence. The C/T ratio was the independent prognostic factor, and all relapsed patients received wedge resections. Even for subcentimeter lung cancers, we should select the extent of pulmonary resection after thoroughly considering whether wedge resection (less invasiveness) is a reasonable alternative to anatomical resection (superior oncologic efficacy) considering the C/T ratio of the lesion.

Sections du résumé

BACKGROUND
Although the opportunity to treat subcentimeter lung cancers has increased, the optimal surgical methods remain unclear. We performed a retrospective study to examine the clinical outcome of subcentimeter lung cancers.
PATIENTS AND METHODS
In total, 118 patients who underwent curative resection for subcentimeter lung cancer from January 2005 to December 2013 were analyzed. Multivariate Cox proportional hazards models were used to calculate the hazard ratio to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS).
RESULTS
Anatomical resections were performed for 64 patients (59 lobectomies and 5 segmentectomies) and wedge resections for 54 patients. Recurrence developed in six patients who had consolidation-predominant tumors (consolidation/tumor [C/T] ratio of >0.5) and underwent wedge resections. The first recurrence patterns were regional recurrences in three patients, both regional and distant in one, and distant in two. Seventeen patients died of other causes. The multivariate analysis revealed that the C/T ratio was the independent predictor of RFS (
CONCLUSION
Patients with subcentimeter lung cancer rarely developed recurrence. The C/T ratio was the independent prognostic factor, and all relapsed patients received wedge resections. Even for subcentimeter lung cancers, we should select the extent of pulmonary resection after thoroughly considering whether wedge resection (less invasiveness) is a reasonable alternative to anatomical resection (superior oncologic efficacy) considering the C/T ratio of the lesion.

Identifiants

pubmed: 36323327
doi: 10.1055/s-0042-1758072
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

214-221

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Takeshi Kawaguchi (T)

Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan.

Daiki Yoshikawa (D)

Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan.

Tokiko Nakai (T)

Department of Diagnostic Pathology, Nara Medical University, Nara, Japan.

Chiho Ohbayashi (C)

Department of Diagnostic Pathology, Nara Medical University, Nara, Japan.

Noriyoshi Sawabata (N)

Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan.

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