Korean J Thorac Cardiovasc Surg.  2018 Dec;51(6):376-383. 10.5090/kjtcs.2018.51.6.376.

Surgical Outcomes of Radiographically Noninvasive Lung Adenocarcinoma according to Surgical Strategy: Wedge Resection, Segmentectomy, and Lobectomy

• Ha KJ
• Yun JK
• Lee GD
• Cho WC
• Choi SH
• Kim HR
• Kim YH
• Kim DK
• Park SI

• KMID: 2433878
• DOI: http://doi.org/10.5090/kjtcs.2018.51.6.376

Abstract

BACKGROUND
The aim of this study was to evaluate the outcomes of surgical resection in patients with radiographically noninvasive lung adenocarcinoma according to the surgical strategy.
METHODS
A retrospective study was conducted of 128 patients who underwent pulmonary resection for ground-glass opacity (GGO)-dominant nodules measuring ≤2 cm with a consolidation/tumor ratio ≤0.25 based on computed tomography between 2008 and 2015. The 5-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were analyzed.
RESULTS
Among the 128 patients, wedge resection, segmentectomy, and lobectomy were performed in 40 (31.2%), 22 (17.2%), and 66 patients (51.6%), respectively. No significant differences were found among the groups in the mean size of tumors (p=0.119), the rate of pure-GGO nodules (p=0.814), the consolidation/tumor ratio (p=0.695), or the rate of invasive adenocarcinoma (p=0.378). Centrally located tumors were more common in the lobectomy group (21.2%) than in the wedge resection (0%) or segmentectomy (0%) groups (p=0.001). There were no significant differences in the 5-year DFS rate (100%, 100%, 92.7%, respectively; p=0.76) or 5-year OS rate (100%, 100%, 100%; p=0.223) among the wedge resection, segmentectomy, and lobectomy groups.
CONCLUSION
For radiographically noninvasive lung adenocarcinoma measuring ≤2 cm with a consolidation/tumor ratio ≤0.25, wedge resection and segmentectomy could be comparable surgical options to lobectomy.

Keyword

Adenocarcinoma; Nodules, solitary pulmonary; Lobectomy; Chest; Computed tomography

MeSH Terms

Adenocarcinoma*
Disease-Free Survival
Humans
Lung*
Mastectomy, Segmental*
Retrospective Studies
Solitary Pulmonary Nodule
Thorax