title: The Outcomes of a Limited Resection for Non-Small Cell Lung Cancer Based on Differences in Pathology.
abstract: A precise preoperative diagnosis of in situ or minimally invasive carcinoma may identify patients who can be treated by limited resection. Although some clinical trials of limited resection for lung cancer have started, it will take a long time before the results will be published. We have already reported a large-scale study of limited resection. We herein report the data for a subclass analysis according to differences in pathology.
  
  
  
  Data from multiple institutions were collected on 1710 patients who had undergone limited resection (segmentectomy or wedge resection) for cT1N0M0 non-small cell carcinoma. The disease-free survival (DFS) and recurrence-free proportion (RFP) were analyzed. Small cell carcinomas and carcinoid tumors were excluded from this analysis. Adenocarcinomas were sub-classified into four groups using two factors, the ratio of consolidation to the tumor diameter (C/T) and the tumor diameter alone.
  
  
  
  The median patient age was 64 (20-75) years old. The mean maximal diameter of the tumors was 1.5 ± 0.5 cm. The DFS and RFP at 5 years based on the pathology were 92.2 and 94.7 % in adenocarcinoma (n = 1575), 76.3 and 82.4 % in squamous cell carcinoma (SqCC) (n = 100), and 73.6 and 75.9 % in patients with other tumors (n = 35). The prognosis of adenocarcinoma in both groups A (C/T ≤0.25 and tumor diameter ≤2.0 cm) and B (C/T ≤0.25 and tumor diameter >2.0 cm) was good. In SqCC, only segmentectomy was a favorable prognostic factor. In the groups with other pathologies, large cell carcinomas were worse in prognosis (the both DFS and RFP: 46.3 %).
  
  
  
  Knowing the pathological diagnosis is important to determine the indications for limited resection. Measurement of the tumor diameter and C/T was useful to determine the indications for limited resection for adenocarcinoma. Limited resection for adenocarcinomas is similar with a larger resection, while the technique should be performed with caution in squamous cell carcinoma and other pathologies.
authors.affiliation: Department of Oncology, Immunology and Surgery, Nagoya City, University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan. motoki@med.nagoya-cu.ac.jp.
authors.forename: Motoki
authors.initials: M
authors.lastname: Yano
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yoshida
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Terumoto
authors.initials: T
authors.lastname: Koike
authors.affiliation: Department of Thoracic Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kameyama
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Shimamoto
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Nishio
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshimoto
authors.affiliation: Department of Surgery, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Utsumi
authors.affiliation: Department of Thoracic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shiina
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Thoracic Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamato
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Nishi-Niigata Chuo National Hospital, Niigata, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.affiliation: Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Oda
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tanahashi
authors.affiliation: Department of Thoracic Surgery, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Thoracic Surgery, Tenri Hospital, Nara, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Surgery and Clinical Science, Division of Chest Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Masataro
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Chest Surgery, Toho University Omori Medical Center, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Otsuka
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Teruaki
authors.initials: T
authors.lastname: Mizobuchi
authors.affiliation: Division of Thoracic Surgery, Chiba Cancer Center, Chiba, Japan.
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Moriya
authors.affiliation: Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Division of Thoracic Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Nishikawa
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan.|Division of Chest Surgery, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Oncology, Immunology and Surgery, Nagoya City, University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Moriyama
authors.affiliation: Department of Oncology, Immunology and Surgery, Nagoya City, University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult