A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer

Suzuki, Kenji; Watanabe, Shun‐ichi; Wakabayashi, Masashi; Saji, Hisashi; Aokage, Keiju; Moriya, Yasumitsu; Yoshino, Ichiro; Tsuboi, Masahiro; Nakamura, Shinichiro; Nakamura, Kenichi; Mitsudomi, Tetsuya; Asamura, Hisao

doi:10.1016/j.jtcvs.2020.09.146

Cited by 224 publications

(153 citation statements)

References 30 publications

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“…Moreover, based on the JCOG0201 study, the results of JCOG0804/WJOG4507L further demonstrated that for GGO dominant peripheral lung cancer, sublobar resection was suitable. And the study of JCOG0802/WJOG4506L have confirm that segmentectomy is the standard procedure in NSCLC patients with tumor ≤ 2 cm, CTR >0.5 ( 22 ).…”

Section: Resultsmentioning

confidence: 95%

Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Wang

Zhang³

et al. 2021

Front. Surg.

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Background: In 1995, a clinical randomized controlled study (RCT) conducted by the Lung Cancer Study Group (LCSG) pointed out that the lobectomy was the gold standard for treating early lung cancer. However, with the development of technology, the results of several retrospective studies have shown that the efficacy of pulmonary segmentectomy is equivalent to that of lobectomy. Currently, it is still controversial whether segmental resection or lobectomy should be performed for early lung cancer. Thus, we aim to summarize the indications of segmentectomy.Methods: To conduct the review, previous researches involving indications of segmentectomy were collected from the literature using Pubmed. These articles were published and accepted in English in the medical literature from 2013 to 2020. We have focused on segmentectomy and its indications.Results: A total of 176 articles were retrieved from the Pubmed database, of which 31 articles included indications for segmentectomy. We summarized the relevant content, and the potential and prospect of segmentectomy for the treatment of lung cancer were emphasized.Conclusions: These findings have a number of important implications for future practice. Pulmonary segmentectomy is a very vital surgical procedure for select patients with lung cancer, which provides a novel approach for the treatment of lung cancer and the survival of lung cancer patients.

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Section: Resultsmentioning

confidence: 95%

Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Wang

Zhang³

et al. 2021

Front. Surg.

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“…Among the 20 adenocarcinomas, 2 were AIS, 8 were MIAs, 1 was lepidic predominant adenocarcinoma (LPA), and 9 were acinar predominant adenocarcinomas (APAs). Despite the pathological diagnosis of invasive adenocarcinomas (LPA and APA), we did not perform extensive resection since it has been reported that ground-glass opacity (GGO)-predominant nodules also have a good prognosis after sublobectomy according to JCOG0804/WJOG4507L Study (18).…”

Section: Resultsmentioning

confidence: 99%

Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules

Chu

Chen

Lin

et al. 2021

Transl Lung Cancer Res

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Background: Some pulmonary nodules are not suitable for computed tomography-guided percutaneous localization. This study aimed to investigate the feasibility and safety of real-time localization for these nonpalpable pulmonary nodules using watershed analysis of the target pulmonary artery during thoracoscopic wedge resection.Methods: Watershed analysis is a novel technique that can be used to create a specific area on the lung surface for nodule localization. This analysis is performed by temporarily blocking the target pulmonary artery and using indocyanine green fluorescence during surgery. In our study, the surgery was simulated and evaluated preoperatively using a high-precision three-dimensional reconstruction model obtained by multidetector spiral computed tomography. The lung was observed using an infrared thoracoscopy system after an intravenous injection of indocyanine green (2.5 mg/mL), and the white-to-blue transitional zone was marked using electrocautery, after which a wedge resection was performed.Results: A total of 25 out of 26 patients underwent successful wedge resection. The mean tumor size and depth based on computed tomography scans were 13.2±6.4 and 12.2±7.8 mm, respectively. The mean operation duration was 142.6±52.8 min. The mean bleeding volume during surgery was 12.9±9.7 mL. The mean drainage tube indwelling time was 35.6±20.0 h, and the median length of postoperative stay was 3 days (range, 2-6 days).Conclusions: Our experience showed that the watershed analysis of the target pulmonary artery for nodule localization was safe and feasible. It may become an effective and attractive alternative method for localizing non-palpable pulmonary nodules in selected patients undergoing thoracoscopic wedge resection.

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“…The selection criteria were maximum tumor diameter ≤ 20 mm, CTR ≤ 0.25, no recurrence of the original lung cancer, and a 5-year RFS rate of 99.7% after sublober resection, primarily wedge resection (Table 1). Their results were clearer and showed that HRCT was very useful in selecting patients suitable for sublobar resection (11).…”

Section: Prognosis Of Nsclc With Ggo Component and Sublobar Resectionmentioning

confidence: 99%

Transition of Treatment for Ground Glass Opacity–Dominant Non-Small Cell Lung Cancer

Handa

Tsutani

2021

Front. Oncol.

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Lobectomy has been the standard surgical treatment for non-small cell lung cancer (NSCLC). Over the decades, with the dramatic development of radiographic tools, such as high-resolution computed tomography (HRCT), and the widespread practice of low-dose helical CT for screening, the number of cases diagnosed with small-cell lung cancers with ground glass opacity (GGO) at early stages has been increasing. Accordingly, mainly after 2000, many retrospective studies and prospective trials have shown that patients with lung adenocarcinoma with GGO have a good prognosis and may be candidates for sublobar resection. Previous studies indicated that HRCT findings including the maximum diameter of the tumor, GGO ratio, and a consolidation/tumor ratio (CTR) are simple and useful tools to predict tumor invasiveness and prognosis in patients with NSCLC with GGO. Thus, sublobar resection may be considered a “standard therapy” for peripheral GGO-dominant small-cell lung adenocarcinomas. Ultimately, some of such tumors might not require surgical resection. A multicenter, prospective study has just begun in Japan to evaluate the validity of follow-up for small-sized GGO-dominant small-cell lung cancer. Lung cancers that do not require surgery should be identified. This study reviewed retrospective and prospective studies on GGO tumors and discussed the treatment strategies for such tumors.

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A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer

Cited by 224 publications

References 30 publications

Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules

Transition of Treatment for Ground Glass Opacity–Dominant Non-Small Cell Lung Cancer

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