A Dominant Adenocarcinoma With Multifocal Ground Glass Lesions Does Not Behave as Advanced Disease

Gu, Bingxin; Burt, Bryan M.; Merritt, Robert E.; Stephanie, Stephanie; Nair, Viswam S.; Hoang, Chuong D.; Shrager, Joseph B.

doi:10.1016/j.athoracsur.2013.04.048

Cited by 66 publications

(43 citation statements)

References 21 publications

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“…Several studies addressing this topic have reported similar results, demonstrating a favorable prognosis [5,[12][13][14][15]. The 5-year OS and RFS proportions of our data were satisfactory and all the patients with multifocal pure GGOs remained alive for 5 years without recurrence, similarly to several previous studies [5,14,15].…”

Section: Discussionsupporting

confidence: 90%

Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesions

et al. 2015

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Section: Discussionsupporting

confidence: 90%

Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesions

et al. 2015

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“…11,30,37,38 Given the lack of radiographic characteristics within the NCDB, our analysis is not able to adjust for this potential clinical feature. Likewise, the extent of lymph node analysis in terms of dissection versus sampling is unknown.…”

Section: Discussionmentioning

confidence: 99%

The Role of Extent of Surgical Resection and Lymph Node Assessment for Clinical Stage I Pulmonary Lepidic Adenocarcinoma: An Analysis of 1991 Patients

Cox

Yang

Speicher

et al. 2017

Journal of Thoracic Oncology

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Background This study examined the association of extent of lung resection, pathologic nodal evaluation, and survival for patients with clinical stage I (cT1-2N0M0) adenocarcinoma with lepidic histology in the National Cancer Database (NCDB). Methods The association between extent of surgical resection and long-term survival for patients in the NCDB with clinical stage I lepidic adenocarcinoma who underwent lobectomy or sublobar resection was evaluated using Kaplan-Meier and Cox proportional hazards regression analyses. Results Of the 1,991 patients with cT1-2N0M0 lepidic adenocarcinoma who met study criteria, 1,544 patients underwent lobectomy and 447 underwent sublobar resections. Patients treated with sublobar resection were older, more likely to be female, had higher Charlson/Deyo comorbidity scores, but had smaller tumors and lower T-status. Of patients treated with lobectomy, 6% (n=92) were upstaged due to positive nodal disease, with a median of 7 lymph nodes sampled (IQR: 4,10). In an analysis of the entire cohort, lobectomy was associated with a significant survival advantage over sublobar resection in univariate analysis (median survival 9.2 vs. 7.5 years, p=0.022; 5-year survival 70.5% vs. 67.8%) and following multivariable adjustment (hazard ratio [HR]: 0.81 [95% [CI]: 0.68–0.95], p=0.011), (Figure 1). However, lobectomy was no longer independently associated with improved survival when compared to sublobar resection (HR: 0.99 [95% CI: 0.77–1.27], p= 0.905) in a multivariable analysis of a subset of patients that compared only those patients who underwent sublobar resection that included lymph node sampling to patients treated with lobectomy. Conclusions Surgeons treating patients with stage I lung adenocarcinoma with lepidic features should cautiously utilize sublobar resection rather than lobectomy and must always perform adequate pathologic lymph node evaluation.

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“…Pulmonary lesions are quite commonly found in the clinic with the application of computed tomography (CT). Some cases involve multiple primary lesions and usually present as ground glass opacity (GGO), with an overall survival of 100% with surgical treatment . Other cases present as metastatic lesions .…”

Section: Introductionmentioning

confidence: 99%

Modified hook‐wire placement technique for localizing multiple pulmonary nodules

Kadeer

Wang

Zhang

et al. 2018

Journal of Surgical Oncology

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Background The localization of multiple pulmonary nodules is challenging due to a high incidence of pneumothorax after each needle insertion into lung parenchyma. The aim of the current study is to verify the safety and effectiveness of a modified technique utilizing simultaneous Hookwire placement to localize multiple lesions. Methods The proposed method comprises a row of metal wires, perpendicular insertion, simultaneous release of Hookwire, and a lateral position to modify a conventional localizing technique. From January 2015 to August 2016, 23 patients were subjected to the modified technique group (Group A), while 53 patients in the conventional group (Group B). Success rates, procedural parameters, and complications were recorded and analyzed. Results Compared with Group B, Group A had higher success rate of lesion (96.7% vs 83.5%, P = 0.009), lower numbers of CT scans (2.91 vs 5.59, P < 0.001), shorter procedure duration (13.83 minutes vs 22.68 minutes, P < 0.001), and shorter distance between localizers and lesions (4.88 vs 6.29, P = 0.006). The incidence of pneumothorax in Group A was lower (21.8% vs 54.7%, P = 0.008), while lung hemorrhage was not significantly different ( P = 0.735). Lesion number and pneumothorax were risk factors for failure in multiple localizations. Conclusions The modified Hookwire placement technique was feasible and successful, which was associated with fewer computed tomography scans, shorter procedure duration, and a lower incidence of pneumothorax.

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A Dominant Adenocarcinoma With Multifocal Ground Glass Lesions Does Not Behave as Advanced Disease

Cited by 66 publications

References 21 publications

Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesions

Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesions

The Role of Extent of Surgical Resection and Lymph Node Assessment for Clinical Stage I Pulmonary Lepidic Adenocarcinoma: An Analysis of 1991 Patients

Modified hook‐wire placement technique for localizing multiple pulmonary nodules

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