Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12524

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    P3.07-029 - Clinicopathological Features of Resected Subcentimeter Lung Cancer (ID 2253)

    09:30 - 09:30  |  Author(s): H. Sakurai
    • Abstract

    Background
    Background. Subcentimeter lung cancers are still rare and their pathobiological behavior and management have not yet been fully clarified. In this retrospective study, we investigated the clinicopathological characteristics of patients with subcentimeter lung cancers.

    Methods
    Methods. From among 7,463 patients with primary lung cancers that were surgically resected at the National Cancer Center Hospital, Tokyo, from 1993 through 2011, 291 (4%) patients with peripheral lung cancers of 1.0 cm or less in diameter were studied retrospectively with regard to their clinicopathological characteristics including prognosis. Of these 291 patients, 141 (48%) were male and 150 (52%) were female, and they had a mean age of 62.0 years. According to the proportion of consolidation component within the tumor in preoperative imaging on high-resolution computed tomography (HRCT), the tumors were classified into 4 types; Type 1 (n = 50): non-solid ground-glass opacity (GGO) lesion, Type 2 (n = 89): part-solid GGO lesion including 50% or more GGO within the lesion, Type 3 (n = 62): part-solid GGO lesion including less than 50% GGO within the lesion, and Type 4 (n = 90): solid lesion with no GGO component.

    Results
    Results. Patients with Type 4 included significantly greater percentages of males and smokers than those with the other types. Pleural invasion and vascular/lymphatic permeation were significantly more frequent in Type 4 than in the other types. While none of the patients with Type 1 to 3 had lymph node metastases, these were found in 10% of the patients with Type 4. Overall, recurrence was observed in 13 patients (4.5%). Almost all of these patients with recurrence had Type 4 tumors. The lone exception was a Type 3 patient in whom local recurrence developed adjacent to a surgical staple line. The 5-year overall survival rates were 100% in Type 1 and Type 2, 98% in Type 3, and 88% in Type 4. Patients with Type 4 had a significantly worse prognosis than those with other types.

    Conclusion
    Conclusions. Subcentimeter lung cancers with a GGO component on preoperative HRCT (Type 1 to 3) can be considered “early” lung cancers. Thus, in these cases, limited resection may be warranted to achieve a cure because patients with Type 1 to 3 did not have lymph node metastasis. On the other hand, lobectomy should still be considered the standard operation of choice for Type 4 tumors.