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  P3.04 - Poster Session with Presenters Present (ID 474)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

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    P3.04-017 - Wedge Resection for Clinical-n0 Non-Small Cell Lung Cancer (ID 4564)

    14:30 - 14:30  |  Author(s): H. Tsunezuka
    • Abstract
    • Slides

    Background:
    Sublobar resection is generally indicated for small ground-glass opacity (GGO)-dominant clinical T1 adenocarcinomas below 2 cm in diameter. Recently, some reports show that GGO-dominant clinical T2 adenocarcinomas measuring below 3 cm are also favorable prognosis after segmentectomy. The aim of this study was to evaluate the prognosis of the patients with non-small cell lung cancers after wedge resection.
    
    Methods:
    From 2008 to 2012, 66 patients underwent wedge resection for clinical-N0 lung cancer at Kyoto Prefectural University of Medicine. Patients who had multiple tumours or previously underwent lung surgeries were not included. The median age of the subjects was 73.0 years. High-resolution computed tomography (HRCT) was performed for preoperative staging of the entire lung cancer. The median tumour size was 2.2 cm. All tumours were evaluated to estimate the GGO on HRCT. We defined the ratio of the maximum diameter of the consolidation to the maximum tumour diameter as the consolidation-to-tumour ratio (CTR). All the patients who underwent wedge resection were followed up with HRCT every 6 months for the first 2 years and every 12 months for the subsequent 3 years. The median postoperative follow-up period was 41.5 months. The Kaplan-Meier method was used to assess recurrence-free survival (RFS) and 5-year overall survival (OS), which were statistically analyzed using the log-rank test. We set the significance level at p<0.05.
    
    Results:
    Twenty two (33.3%) of the 66 patients had GGO-dominant tumours with CTR of less than 50%, and have survived without recurrence. The 5-year OS, RFS and CSS of whole patients were 66.1%, 53.4% and 81.6% respectively. The 5-year OS significantly differed according to CTR and solid tumour size. The 5-year RFS significantly differed according to CTR, solid tumour size, CEA level, and histological type. No significant differences in sex, whole tumour size and Brinkman index were observed. Multivariate Cox proportional hazard model revealed that solid tumour size and CTR were independent prognostic factors for OS, RFS and CSS. Lung cancer death accounted for 10 of the 20 cause of death, leading cause of death of remaining half was 7 other malignant tumours. 18 patients experienced a recurrence of lung cancer. Site of recurrence was 8 lung parenchyma including 2 stump recurrences, 8 mediastinal lymph node, 4 pleural dissemination and 4 distant organ.
    
    Conclusion:
    A solid tumour size <1.2cm and CTR <50 might be a good, radiologically noninvasive indicator for performing wedge resection of clinical-N0 non-small cell lung cancer.
    
    

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