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Thorac Cardiovasc Surg 2023; 71(03): 214-221
DOI: 10.1055/s-0042-1758072
Original Thoracic

Outcome of Resected Lung Cancers with Subcentimeter Solid Component on Computed Tomography

Takeshi Kawaguchi
1   Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan
,
Daiki Yoshikawa
1   Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan
,
Tokiko Nakai
2   Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
,
Chiho Ohbayashi
2   Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
,
Noriyoshi Sawabata
1   Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan
› Author Affiliations Funding None.
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Abstract

Background Although the opportunity to treat subcentimeter lung cancers has increased, the optimal surgical methods remain unclear. We performed a retrospective study to examine the clinical outcome of subcentimeter lung cancers.

Patients and Methods In total, 118 patients who underwent curative resection for subcentimeter lung cancer from January 2005 to December 2013 were analyzed. Multivariate Cox proportional hazards models were used to calculate the hazard ratio to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS).

Results Anatomical resections were performed for 64 patients (59 lobectomies and 5 segmentectomies) and wedge resections for 54 patients. Recurrence developed in six patients who had consolidation-predominant tumors (consolidation/tumor [C/T] ratio of >0.5) and underwent wedge resections. The first recurrence patterns were regional recurrences in three patients, both regional and distant in one, and distant in two. Seventeen patients died of other causes. The multivariate analysis revealed that the C/T ratio was the independent predictor of RFS (p = 0.008) and OS (p = 0.011).

Conclusion Patients with subcentimeter lung cancer rarely developed recurrence. The C/T ratio was the independent prognostic factor, and all relapsed patients received wedge resections. Even for subcentimeter lung cancers, we should select the extent of pulmonary resection after thoroughly considering whether wedge resection (less invasiveness) is a reasonable alternative to anatomical resection (superior oncologic efficacy) considering the C/T ratio of the lesion.

Keywords

subcentimeter lung cancer - surgery - high-resolution computed tomography - prognosis

Authors' Contribution

T.K. contributed to conceptualization, data curation, formal analysis, and writing original draft. D.Y. and T.N. contributed to data curation. C.O. and N.S. contributed to supervision, and writing review and editing.




Publication History

Received: 25 July 2022

Accepted: 15 September 2022

Article published online:
02 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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