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Lobectomy versus Sublobar Resection in Non-Lepidic Small-Sized Non-Small Cell Lung Cancer

  • Namkoong, Min (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Moon, Youngkyu (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Jae Kil (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2017.01.18
  • Accepted : 2017.05.09
  • Published : 2017.12.05

Abstract

Background: Recently, many surgeons have chosen sublobar resection for the curative treatment of lung tumors with ground-glass opacity, which is a hallmark of lepidic lung cancer. The purpose of this study was to evaluate the oncological results of sublobar resection for non-lepidic lung cancer in comparison with lobectomy. Methods: We conducted a retrospective chart review of 328 patients with clinical N0 non-small cell lung cancer sized ${\leq}2cm$ who underwent curative surgical resection from January 2009 to December 2014. The patients were classified on the basis of their lesions into non-lepidic and lepidic groups. The survival rates following lobectomy and sublobar resection were compared within each of these 2 groups. Results: The non-lepidic group contained a total of 191 patients. The 5-year recurrence-free survival rate was not significantly different between patients who received sublobar resection or lobectomy in the non-lepidic group (80.1% vs. 79.2%, p=0.822) or in the lepidic group (100% vs. 97.4%, p=0.283). Multivariate analysis indicated that only lymphatic invasion was a significant risk factor for recurrence in the non-lepidic group. Sublobar resection was not a risk factor for recurrence in the non-lepidic group. Conclusion: The oncological outcomes of sublobar resection and lobectomy in small-sized non-small cell lung cancer did not significantly differ according to histological type.

Keywords

References

  1. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995;60:615-22. https://doi.org/10.1016/0003-4975(95)00537-U
  2. Taioli E, Yip R, Olkin I, et al. Survival after sublobar resection for early-stage lung cancer: methodological obstacles in comparing the efficacy to lobectomy. J Thorac Oncol 2016;11:400-6. https://doi.org/10.1016/j.jtho.2015.10.022
  3. Cao C, Chandrakumar D, Gupta S, Yan TD, Tian DH. Could less be more?: a systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer 2015;89:121-32. https://doi.org/10.1016/j.lungcan.2015.05.010
  4. Blasberg JD, Pass HI, Donington JS. Sublobar resection: a movement from the Lung Cancer Study Group. J Thorac Oncol 2010;5:1583-93. https://doi.org/10.1097/JTO.0b013e3181e77604
  5. Nakamura K, Saji H, Nakajima R, et al. A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol 2010;40:271-4. https://doi.org/10.1093/jjco/hyp156
  6. Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 2011;6:244-85. https://doi.org/10.1097/JTO.0b013e318206a221
  7. Eguchi T, Kadota K, Park BJ, Travis WD, Jones DR, Adusumilli PS. The new IASLC-ATS-ERS lung adenocarcinoma classification: what the surgeon should know. Semin Thorac Cardiovasc Surg 2014;26:210-22. https://doi.org/10.1053/j.semtcvs.2014.09.002
  8. Moon Y, Sung SW, Lee KY, Kim YK, Park JK. The importance of the lepidic component as a prognostic factor in stage I pulmonary adenocarcinoma. World J Surg Oncol 2016;14:37. https://doi.org/10.1186/s12957-016-0791-y
  9. Yoshida J, Nagai K, Yokose T, et al. Limited resection trial for pulmonary ground-glass opacity nodules: fifty-case experience. J Thorac Cardiovasc Surg 2005;129:991-6. https://doi.org/10.1016/j.jtcvs.2004.07.038
  10. Nitadori J, Bograd AJ, Morales EA, et al. Preoperative consolidation-to-tumor ratio and SUVmax stratify the risk of recurrence in patients undergoing limited resection for lung adenocarcinoma ${\leq}$2 cm. Ann Surg Oncol 2013;20:4282-8. https://doi.org/10.1245/s10434-013-3212-2
  11. Cho JH, Choi YS, Kim J, Kim HK, Zo JI, Shim YM. Long-term outcomes of wedge resection for pulmonary ground-glass opacity nodules. Ann Thorac Surg 2015;99:218-22. https://doi.org/10.1016/j.athoracsur.2014.07.068
  12. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th ed. New York (NY): Springer; 2010.
  13. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization Classification of Lung Tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol 2015;10:1243-60. https://doi.org/10.1097/JTO.0000000000000630
  14. Moon Y, Kim KS, Sung SW, et al. Correlation of histological components with tumor invasion in pulmonary adenocarcinoma. World J Surg Oncol 2014;12:388. https://doi.org/10.1186/1477-7819-12-388
  15. Sasada S, Nakayama H, Miyata Y, et al. Comparison of malignant grade between pure and partially invasive types of early lung adenocarcinoma. Ann Thorac Surg 2015;99:956-60. https://doi.org/10.1016/j.athoracsur.2014.10.041
  16. Yanagawa N, Shiono S, Abiko M, Ogata SY, Sato T, Tamura G. The correlation of the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification with prognosis and EGFR mutation in lung adenocarcinoma. Ann Thorac Surg 2014;98:453-8. https://doi.org/10.1016/j.athoracsur.2014.04.108
  17. Koike T, Kitahara A, Sato S, et al. Lobectomy versus segmentectomy in radiologically pure solid small-sized non-small cell lung cancer. Ann Thorac Surg 2016;101:1354-60. https://doi.org/10.1016/j.athoracsur.2015.10.048
  18. Altorki NK, Kamel MK, Narula N, et al. Anatomical segmentectomy and wedge resections are associated with comparable outcomes for patients with small cT1N0 non-small cell lung cancer. J Thorac Oncol 2016;11:1984-92. https://doi.org/10.1016/j.jtho.2016.06.031

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