Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates for wedge resection

Nakamura, Hiroki; Saji, Hisashi; Ogata, Akihiko; Saijo, Takamoto; Okada, Shinya; Kato, Harubumi

doi:10.1016/j.lungcan.2003.09.025

Cited by 87 publications

(55 citation statements)

References 23 publications

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“…In our study (Nakamura et al, 2004), analyzsng 100 patients who underwent limited resection without systematic lymph node dissection, the overall 5-year survival rate for 73 patients with small adenocarcinomas (p2 cm) was 93.7%, which was significantly better than for those with larger adenocarcinomas (24.8%). In addition, we found the overall 5-year survival rate for patients with well-differentiated adenocarcinoma (81.2%) to be significantly better than for a group combining moderately and poorly differentiated adenocarcinomas (30.7%).…”

Section: Discussionmentioning

confidence: 63%

“…One example would be a small, slowly growing, localised bronchioloalveolar carcinoma showing only ground-glass opacity (GGO) on computed tomography (Kaneko et al, 1996;Sone et al, 1998). In our opinion, these lesions can be resected Survival in lobectomy vs limited resection H Nakamura et al completely by VATS wedge resection (Watanabe et al, 2002;Nakamura et al, 2004), given their low invasiveness and absence of lymph node metastases (Nakata et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…However, considerable heterogeneity among studies suggests that clinicopathologic features of patients who underwent limited resection in the studies analysed were quite different. We believe that some lung cancers can be cured by limited resection, if we can identify tumours of minimally invasive nature, such as small bronchioloalveolar carcinomas diagnosed by CT (Nakamura et al, 2004). Further clinicopathologic studies of the biologic nature of various lung cancers should help to address this problem.…”

Section: Discussionmentioning

confidence: 99%

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Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

et al. 2005

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Extent of resection needed to treat lung cancer has long been an issue. The sole randomised controlled trial, reported by the Lung Cancer Study Group, advised against limited resection as standard surgery even for small peripheral non-small-cell lung cancers (p3 cm), because of frequent local recurrences. Elsewhere, conflicting results have been reported from different institutions. We therefore conducted a meta-analysis of reported studies to compare survival of stage I patients between limited resection and standard lobectomy. A MEDLINE web search for computer-archived bibliographic data yielded 14 articles suitable for analysis. Combined survival differences (survival rate with lobectomy minus that with limited resection) at 1, 3, and 5 years after resection according to the DerSimonian -Laird random effects model were 0.7% (95% CI, À0.8 to 2.1; P ¼ 0.3659), 1.9% (95% CI, À3.7 to 7.4; P ¼ 0.5088), and 3.6% (95% CI, À0.4 to 10.5; P ¼ 0.3603), respectively. None of these survival differences were significant, indicating that survival after limited resection for stage I lung cancer was comparable to that after lobectomy. However, since interstudy heterogeneity was detected, caution is required in interpretation of the results.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

et al. 2005

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“…Table 2 summarises the data from nine Japanese reports focused on the surgical treatment of small BACs, currently f2 cm in diameter or less, although two series include larger tumours [13,[55][56][57][58][59][60][61][62]. In most reports, these small BACs represent ,2% of the lung cancer series, and were treated by either lobectomy or sublobar resection.…”

Section: Combined Therapiesmentioning

confidence: 99%

Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2009

Eur Respir J

102

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Sublobar resection for small lung cancers has been debated frequently and is still a controversial issue. The only randomised trial comparing lobectomy with sublobar resections found a significantly higher recurrence rate for the latter, but failed to show significant differences in survival, although survival was better for the lobectomy group. One meta-analysis and several nonrandomised comparisons have confirmed these results. In general, lobectomy and sublobar resections have similar 5-yr survival rates. Local recurrence after wedge resection is higher than after segmentectomy. However, for patients aged .71 yrs, lobectomy and wedge resection are associated with similar survival. For tumours of f2 cm, segmentectomy is equivalent to lobectomy, but survival after segmentectomy is worse if performed for larger tumours. For both segmentectomy and wedge resection, tumour margins should be o1 cm wide to avoid recurrence. For pure bronchioloalveolar carcinoma of f2 cm, diagnosed intraoperatively with certainty, sublobar resection seems equivalent to lobectomy, and because there is no nodal involvement, systematic nodal dissection may not be necessary. In case of doubt, however, lobectomy with systematic nodal dissection will ensure complete resection and adequate staging. More randomised trials are needed to confirm all these issues.

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“…Interestingly, some recent investigators have begun to address the possibility of lung parenchymal sublobar limited resection for this specific subgroup of small lung cancers with GGO appearance [1][2][3][4][5][6][7]. Although operative procedures are generally dependent on size, number, and location of lesions, limited resection procedures, such as wedge resection, are a well-recognized form of operative procedure for small-sized pure GGO.…”

Section: Introductionmentioning

confidence: 99%

Pathologic and Biological Assessment of Lung Tumors Showing Ground-Glass Opacity

Ohta

Shimizu

Kobayashi

et al. 2006

The Annals of Thoracic Surgery

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Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates for wedge resection

Cited by 87 publications

References 23 publications

Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

Sublobar resection for lung cancer

Pathologic and Biological Assessment of Lung Tumors Showing Ground-Glass Opacity

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