title: Wedge resection margin distances and residual adenocarcinoma in lobectomy specimens.
abstract: We studied 31 T1 N0 M0 peripheral adenocarcinomas diagnosed by wedge resection and treated by lobectomy. Factors recorded were pleural surface-based, gross cut-surface, and microscopic margin distances; morphologic features of the adenocarcinomas; microscopic extension distance of beyond gross perimeter of neoplasm; and presence of residual adenocarcinoma in the lobectomy specimen. All staple-line margins in the wedge and lobectomy specimens underwent complete histologic examination. The mean pleural surface-based, gross cut-surface, and microscopic margin distances in wedge resections were 13.1, 4.1, and 2.3 mm, respectively. The mean microscopic wedge resection margin distance was 11 mm smaller than the pleural surface-based measured margin. The mean microscopic lepidic growth beyond the gross perimeter of the neoplasm was 7.4 mm. Fourteen lobectomy specimens (45%) included adenocarcinoma. The mean microscopic wedge resection specimen margin distances in cases with and without residual adenocarcinoma in the lobectomy specimens were 0.7 and 2.4 mm, respectively (P < .001). Incomplete excision may contribute to higher locoregional recurrence rates following limited resection surgery. Two processes affected wedge resection margin distances: stapling-induced parenchymal stretching, resulting in overestimation of pleural surface-based distances, and microscopic extension of adenocarcinoma beyond the gross perimeter of the neoplasm.
authors: Dept of Anatomic Pathology, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073, USA.
authors: Neal S
authors: NS
authors: Goldstein
authors: Monica
authors: M
authors: Ferkowicz
authors: Larry
authors: L
authors: Kestin
authors: Gary W
authors: GW
authors: Chmielewski
authors: Robert J
authors: RJ
authors: Welsh
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D011013:Pneumonectomy