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H. Sakaguchi



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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-041 - Study on surgical cases for simultaneous multiple GGNs in bilateral lung (ID 3021)

      09:30 - 09:30  |  Author(s): H. Sakaguchi

      • Abstract

      Background
      In recent years, the opportunity to encounter a ground glass opacity nodule (GGN) by high-resolution CT is increased, and simultaneous multiple GGNs also are not uncommon. A GGN has been usually classified as pure GGN and part-solid GGN, the former seems to correspond to atypical adenomatous hyperplasia (AAH) or adenocarcinoma in situ (AIS) and the latter seems minimally invasive adenocarcinoma (MIA) or invasive adenocarcinoma (IA), but CT image and pathological findings do not necessarily match. Some GGNs are diseases unrelated to primary lung adenocarcinoma. We have examined the resected cases for simultaneous multiple GGNs on both sides of the lung.

      Methods
      Adaptation of resection for GGNs on our hospital is as follows. 1)10-15mm or more size, 2) larger solid component, 3) just below the pleura, 4) increase over time in size or density, 5) the purpose of pathological diagnosis, etc. The prevention of lung function is noted in the resection on both sides of the lung. In this four years, we performed surgery on seven patients with bilateral multiple GGNs for diagnosis and treatment. We investigated the clinical features and histopathological findings of the resected lung.

      Results
      The seven patients consisted of 40 to 70 years old, five women and two men. We performed lobectomy and partial (wedge) resection of three patients. Four patients underwent several wedge resections for pathological diagnosis and treatment. Two women did the two-term surgery on both sides of the lungs. Pathological diagnosis was adenocarcinoma (AIS, MIA, IA) in five cases, AAHs in one, and lymphoproliferative disease in one. In one patient, all three lesions from four wedge resections had different mutated patterns of EGFR. There was no recurrence or death in 13 to 58 months of the observation period.

      Conclusion
      Simultaneous multiple GGNs was more frequent in women than men. Surgical biopsy (wedge resection) seems to be necessary for definitive diagnosis because a GGN may not be related to lung cancer. Even if multiple cancers in bilateral lung are supposed, prognosis may be able improved by surgical removal of more invasive (advanced) lesions in GGNs.