Affordable Access

deepdyve-link
Publisher Website

Indications for sublobar resection of clinical stage IA radiologic pure-solid lung adenocarcinoma.

Authors
  • Hattori, Aritoshi1
  • Matsunaga, Takeshi1
  • Takamochi, Kazuya1
  • Oh, Shiaki1
  • Suzuki, Kenji2
  • 1 Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. , (Japan)
  • 2 Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: [email protected] , (Japan)
Type
Published Article
Journal
The Journal of thoracic and cardiovascular surgery
Publication Date
Sep 01, 2017
Volume
154
Issue
3
Pages
1100–1108
Identifiers
DOI: 10.1016/j.jtcvs.2017.03.153
PMID: 28629842
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of this study was to identify clinical factors associated with lepidic growth in resected clinical stage IA radiologic pure-solid lung adenocarcinoma for identifying a possible sublobar resection candidate in the population. Clinicopathologic data were reviewed for 200 surgically resected clinical stage IA pure-solid lung adenocarcinomas. Radiologic pure-solid tumor was defined as a tumor without a ground-glass opacity component, that is, a consolidation tumor ratio equal to 1.0. Lepidic predominant adenocarcinoma included adenocarcinomas in situ, minimally invasive adenocarcinomas, and lepidic predominant invasive adenocarcinomas. A total of 57 patients (29%) had lepidic predominant adenocarcinoma. The 5-year overall survival of clinical stage IA pure-solid adenocarcinoma was 83.4% and that of lepidic predominant adenocarcinoma and nonlepidic predominant adenocarcinoma was 98.1% versus 76.6% (P = .0012). A multivariate analysis revealed that maximum standardized uptake value was an independently significant variable of lepidic predominant adenocarcinoma (P < .0001) and a significant prognostic factor (P = .034). The predictive criterion of lepidic predominant adenocarcinoma was maximum standardized uptake value 3.3 or less based on a receiver operating characteristic curve, and 77 patients (39%) who met this criterion showed less pathologic invasiveness regarding lymphatic (P = .0012) and vascular (P < .0001) invasions, nodal metastasis (P = .0007), and better overall survival than those who did not (maximum standardized uptake value ≤3.3 vs >3.3 rates being 91.7% vs 78.6%, P = .0031). Moreover, the 3-year locoregional recurrence-free survival of the sublobar resection arm was significantly worse than that of the lobectomy arm when the tumor showed maximum standardized uptake value greater than 3.3 (62.7% vs 82.9%, P = .0281). Higher maximum standardized uptake value may be useful for identifying patients with clinical stage IA radiologic pure-solid lung adenocarcinoma in whom sublobar resection should not be considered, even if technically feasible. Copyright © 2017. Published by Elsevier Inc.

Report this publication

Statistics

Seen <100 times