title: Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates for wedge resection.
abstract: Small lung cancers frequently have been detected in mass screening by computed tomography (CT) in recent years. Suitability of limited resection for these small lung cancers remains controversial. One hundred patients who underwent sublobular limited resection (wedge resection or segmentectomy) for lung cancer in our hospital from 1981 to 2002 were analyzed retrospectively. From CT findings, tumors were classified into two groups; pure ground-glass opacity (PGGO) and non-PGGO. Patients included 44 women and 56 men, and ages ranged from 40 to 92 years (mean, 71.0). Histologic types included 76 adenocarcinomas, 21 squamous cell carcinomas, and 3 large cell carcinomas. Clinical stages included 83 stage IA and 17 stage IB. By high-resolution CT, 27 tumors (27%) showed PGGO; at postoperative histopathologic examination, all of these were localized bronchioloalveolar carcinomas. Diameter of tumors showing PGGO was 9.3+/-mm (mean +/- S.D.); that of non-PGGO tumors was 21.2+/-13.7 mm. Overall and lung cancer-specific 5-year survival rates in all patients were 58.0 and 64.8%, respectively. Overall 5-year survival rate with small adenocarcinomas (<or=20mm) was 93.7%, significantly better than 24.8% with larger adenocarcinomas ( P<0.0001 ). No intrathoracic recurrence or distant metastasis has been observed in PGGO tumors. For peripheral localized bronchioloalveolar carcinoma showing PGGO, wedge resection appears to be the best operation. Definitive study of more patients with longer follow-up is needed.
authors.affiliation: Department of Surgery, Tokyo Medical University Hospital, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. hanakamu@tokyo-med.ac.jp
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hisashi
authors.initials: H
authors.lastname: Saji
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ogata
authors.forename: Takamoto
authors.initials: T
authors.lastname: Saijo
authors.forename: Shinya
authors.initials: S
authors.lastname: Okada
authors.forename: Harubumi
authors.initials: H
authors.lastname: Kato
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010347:Patient Care Planning; D011013:Pneumonectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome