title: Limited resection trial for pulmonary ground-glass opacity nodules: case selection based on high-resolution computed tomography-interim results.
abstract: OBJECTIVE
  Our previous trial for small ground-glass opacity nodule on high-resolution computed tomography suggested all these cancers might have been radically managed with limited resection. Good correlation between radiologic and pathologic findings in early lung adenocarcinomas has been reported. We aimed to confirm limited resection efficacy as radical surgery in patients with high-resolution computed tomography-indicated minimally invasive lung cancer. The purpose of this interim analysis is to report the details of the patient and nodule characteristics, intraoperative cytology capability as a negative margin indicator, and patient outcome with the median follow-up period of 7 years and 4 months.
  
  
  METHODS
  Enrollment required patients with a tumor ≤2 cm, diagnosed or suspected as a cT1N0M0 carcinoma in the lung periphery and depicted on high-resolution computed tomography as a sub-solid nodule with tumor disappearance ratio ≥0.5. We performed a wedge or segmental resection as appropriate. The primary endpoint is 10 year local recurrence-free survival rate.
  
  
  RESULTS
  This study started in November 2003, and 101 patients were enrolled as of November 2009. Of them, 95 were eligible for analysis. There were 38 men and 57 women, aged 30-75, averaging 62 years. Tumor sizes ranged from 7 to 20 mm on computed tomography, averaging 15 mm. There were 11 Noguchi type A tumors, 54 type B tumors, 24 type C tumors, one malignant lymphoma and 5 non-cancerous lesions. All cancers showed no vessel invasion. With a median follow-up period of 88 months, there have been no recurrences.
  
  
  CONCLUSIONS
  So far, high-resolution computed tomography appears to predict non- or minimally invasive ground-glass opacity lung cancers with high reliability, warranting limited resection as curative surgery in this cohort.
authors.affiliation: Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba jyoshida@east.ncc.go.jp.
authors.forename: Junji
authors.initials: J
authors.lastname: Yoshida
authors.affiliation: Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba.
authors.forename: Genichiro
authors.initials: G
authors.lastname: Ishii
authors.affiliation: Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hishida
authors.affiliation: Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba.
authors.forename: Keiju
authors.initials: K
authors.lastname: Aokage
authors.affiliation: Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuboi
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Division of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yokose
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa.
authors.forename: Kouzo
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba.
authors.forename: Kanji
authors.initials: K
authors.lastname: Nagai
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Noguchi classification; ground-glass opacity; high-resolution computed tomography; limited resection; lung cancer