title: Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage IA lung adenocarcinoma: wedge resection or segmentectomy.
abstract: BACKGROUND
  The purpose of this multicenter study was to characterize ground glass opacity (GGO)-dominant clinical stage IA lung adenocarcinomas and evaluate prognosis of these tumors after sublobar resection, such as segmentectomy and wedge resection.
  
  
  METHODS
  We evaluated 610 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection after preoperative high-resolution CT scanning and 18 F-fl uorodeoxyglucose PET/CT scanning and revealed 239 (39.2%) that had a . 50% GGO component.
  
  
  RESULTS
  GGO-dominant tumors rarely exhibited pathologic invasiveness, including lymphatic, vascular, or pleural invasion and lymph node metastasis. There was no significant difference in 3-year recurrence-free survival (RFS) among patients who underwent lobectomy (96.4%), segmentectomy (96.1%), and wedge resection (98.7%) of GGO-dominant tumors ( P = .44). Furthermore, for GGO-dominant T1b tumors, 3-year RFS was similar in patients who underwent lobectomy (93.7%), segmentectomy (92.9%), and wedge resection (100%, P = .66). Two of 84 patients (2.4%) with GGO-dominant T1b tumors had lymph node metastasis. Multivariate Cox analysis showed that tumor size, maximum standardized uptake value on 18 F-fl uorodeoxyglucose PET/CT scan, and surgical procedure did not affect RFS in GGO-dominant tumors.
  
  
  CONCLUSIONS
  GGO-dominant clinical stage IA lung adenocarcinomas are a uniform group of tumors that exhibit low-grade malignancy and have an extremely favorable prognosis. Patients with GGOdominant clinical stage IA adenocarcinomas can be successfully treated with wedge resection of a T1a tumor and segmentectomy of a T1b tumor.
authors.affiliation: Department of Surgical Oncology, Hiroshima University, Hiroshima.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsutani
authors.affiliation: Department of Surgical Oncology, Hiroshima University, Hiroshima.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyata
authors.affiliation: Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Department of Thoracic Surgery, Cancer Institute Hospital, Tokyo.
authors.forename: Sakae
authors.initials: S
authors.lastname: Okumura
authors.affiliation: Department of Radiology, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Adachi
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Department of Surgical Oncology, Hiroshima University, Hiroshima. Electronic address: morihito@hiroshima-u.ac.jp.
authors.forename: Morihito
authors.initials: M
authors.lastname: Okada
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D011013:Pneumonectomy / Q000379:methods*; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed