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H. Shimpo
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-056 - Surgical Results of Thoracoscopic Anatomical Sublobar Resections for Early-Stage Lung Cancer (ID 5390)
14:30 - 14:30 | Author(s): H. Shimpo
- Abstract
Background:
High-resolution computed tomography (HRCT) has been used to detect ground glass nodules (GGN), and sublobar resections might be currently accepted for patients with early stage malignant GGN. Aim of this study was to evaluate the surgical results of thoracoscopic sublobar resections for early-stage lung cancer.
Methods:
Twenty patients (6 males and 14 females, a mean age of 72.5 years) performed surgical treatment for thoracoscopic anatomical sublobar resections from April 2012 to May 2016. Anatomic sublobar resections were selected with the following criteria; stage IA disease with no regional lymph node metastasis; tumor up to 2 cm in diameter; a low tumor standardized uptake value (SUV) evaluated in (18)F fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET) ; predominantly ground-glass appearance on CT imaging. The high resolution CT scanner, Philips Brilliance iCT (Medical Imaging Resources, An Arbor, MI) with both 128 and 256 slice configurations was used. CT data were transferred to an imaging analysis system (Zio station ver.2, Tokyo, Japan) for image reconstruction and we performed preoperative CT-guided marking in surface of near the tumor.
Results:
In all 20 cases, the reconstruction of the pulmonary artery and vein could image branches and resected in lung segment. Right side: One case of the upper lobe S1; 5 cases of the lower lobe S6 (3), S8 (1) and S10 (1). Left side: 10 cases of the upper lobe S1+2a, S1+2c, S1+2a+b, S1+2c+S3a, S3b+c, apicoposterior segmentectomy, S3(2) and upper lober trisegmentectomy (2); 4 cases of the lower lobe S6, S8+S9, S10 and basal segmentectomy. All pulmonary nodules were found in the excised target segments with safety margin. According to postoperative pathological examination of the all operative specimens were adenocarcinoma , and the diameters of pulmonary tumors resected were 15.8±3.3 and invasive size were 6.2±3.1 mm. Furthermore, the pathological results were given Atypical adenomatous hyperplasia (2), adenocarcinoma in situ (2), minimally invasive adenocarcinoma (5), Lepidic predominant adenocarcinoma (10) and papillary predominant adenocarcinoma (1).
Conclusion:
At the time of writing, local recurrences had not occurred in sublobar resection, so we should be considered for early stage lung cancer in these conditions. Moreover the 3D-CT angiography could be used preoperatively as a tracing method to identify the resected line of lung segment and very useful for anatomic sublobar resections, especially in thoracoscopic surgery.
