title: Margin Distance Does Not Influence Recurrence and Survival After Wedge Resection for Lung Cancer.
abstract: BACKGROUND
  The relationship between the free margin distance and the recurrence rate and overall survival after R0 wedge resection for non-small cell lung cancer (NSCLC) is still not clear. We retrospectively evaluated the long-term oncologic outcome of patients who had undergone wedge resection for NSCLC to assess the prognostic effect of margin distance in this setting.
  
  
  METHODS
  Between 2003 and 2013, 243 consecutive patients with a functional contraindication to major lung resection underwent wedge resection with systematic lymph node dissection for clinical stage I NSCLC. The study enrolled 182 patients with pathologic stage I and R0 resection and divided them into three subgroups according to margin distance of less than 1 cm (n = 30), 1 to 2 cm (n = 80), and more than 2 cm (n = 72).
  
  
  RESULTS
  The histologic assessment was adenocarcinoma in 112 patients, squamous cell in 30, and other in 40. Postoperative morbidity was 18.7%, and postoperative mortality was 1.1%. The median follow-up was 31 months (range, 2 to 133 months). The locoregional (lung parenchyma, hilum, mediastinum) recurrence rate was 26.4% (n = 48). The distant recurrence rate was 11% (n = 20). Overall 5-year survival was 70.4%. Disease-free 5-year survival was 51.7%. There was no statistical difference in locoregional (p = 0.9) and distant (p = 0.3) recurrence rate and no difference in overall survival (p = 0.07) when the three groups were compared.
  
  
  CONCLUSIONS
  Wedge resection is a viable option for the surgical treatment of stage I NSCLC when lobectomy is contraindicated. The distance between the tumor and the parenchymal suture margin does not influence recurrence or the survival rate when an R0 resection is achieved.
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. Electronic address: giuliomaurizi@libero.it.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maurizi
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Andrilli
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ciccone
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Andreetti
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Tierno
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Poggi
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Menna
authors.affiliation: Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy; Lorillard-Spencer-Cenci Foundation, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; Lorillard-Spencer-Cenci Foundation, Rome, Italy.
authors.forename: Erino Angelo
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011013:Pneumonectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate