Ha Keong Jun, Yun Jae Kwang, Lee Geun Dong, Cho Won Chul, Choi Se Hoon, Kim Hyeong Ryul, Kim Yong Hee, Kim Dong Kwan, Park Seung-Il
Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Korean J Thorac Cardiovasc Surg. 2018 Dec;51(6):376-383. doi: 10.5090/kjtcs.2018.51.6.376. Epub 2018 Dec 5.
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.
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.
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.
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.
本研究旨在根据手术策略评估影像学表现为非侵袭性的肺腺癌患者手术切除的效果。
对2008年至2015年间128例接受肺切除术的患者进行回顾性研究,这些患者的计算机断层扫描显示以磨玻璃影(GGO)为主的结节直径≤2 cm,实性成分/肿瘤比例≤0.25。分析5年无病生存率(DFS)和5年总生存率(OS)。
128例患者中,分别有40例(31.2%)、22例(17.2%)和66例(51.6%)接受了楔形切除术、肺段切除术和肺叶切除术。各组间肿瘤平均大小(p = 0.119)、纯GGO结节比例(p = 0.814)、实性成分/肿瘤比例(p = 0.695)或浸润性腺癌比例(p = 0.378)无显著差异。中央型肿瘤在肺叶切除组(21.2%)比楔形切除组(0%)和肺段切除组(0%)更常见(p = 0.001)。楔形切除组、肺段切除组和肺叶切除组的5年DFS率(分别为100%、100%、92.7%;p = 0.76)或5年OS率(分别为100%、100%、100%;p = 0.223)无显著差异。
对于影像学表现为非侵袭性、直径≤2 cm且实性成分/肿瘤比例≤0.2,5的肺腺癌,楔形切除术和肺段切除术可能是与肺叶切除术相当的手术选择。