Author of

• 20169

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  P2.05 - Early Stage NSCLC (ID 706)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23358

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    P2.05-015 - Wedge Resection Is Enough for Curing GGO Patients with Minimally Invasive Adenocarcinoma (MIA) of the Lung? (ID 9296)

    09:30 - 09:30  |  Author(s): N. Chen
    • Abstract

    Background:
    More and more pulmonary ground-glass opacity (GGO) were detected and surgically resected, but the resection extent remains unconcluded, especially for those micro- small lung cancer (≤1cm) (mi-SLC), some are adenocarcinoma in situ (AIS), some minimally invasive adenocarcinoma (MIA), both belonging to early stage lung cancer. Wedge resection may be enough for curing lung MIA.
    
    Method:
    Case 1: Woman, aged 59 in Nov 2013, right middle lobe pure GGO 1.0cm, peripheral; sickly weak for years; anti-inflammatory strategy used, GGO size no change. Case 2: man, aged 64 in Oct 2013, right upper lobe mixed GGO 1.0cm, peripheral; with hypertension and chronic bronchitis for years; anti-inflammatory strategy used, the GGO showed a little increased one month later. Both patients were referral to China Medical University Lung Cancer Center for surgical resection, “miMRST”, minimally invasive small incision, muscle- and rib-sparing thoracotomy, minimally invasive lung cancer radical surgery, was scheduled.
    
    Result:
    About 10cm lateral chest incision, with the latissimus dorsi and serratus anterior muscles protected, no rib cut needed, was enough for most lung cancer resection and mediastinal lymph node dissection, no need for the surgeon’s hands entering into the thoracic cavity, not as large-incision standard posterolateral thoracotomy (SPLT) and modified muscle and rib sparing thoracotomy (MRST) usually do. For Case 1, right middle lobe wedge resection was undergone first, frozen pathological diagnosis was atypical adenomatous hyperplasia (AAH), carcinoma should be excluded by following wax slide pathology. For Case 2, right upper lobe wedge resection was performed, frozen diagnosis was AAH, carcinoma should be excluded by following wax slide pathology. Both patients recovered much better and quickly than other patients who underwent SPLT. Postoperative pathology was MIA for both cases. Considering both in a status of sickly and weak health condition, no further tratment was used. Follow-up: both patients are living healthilly, in their 4th year postoperatively, obviously more healthy and stronger than before; no sign of recurrence and metastasis.
    
    Conclusion:
    Even though lobectomy and systematic mediastinal lympph node dissection still remains the standard surgical procedure for non-small cell lung cancer, more and more limited (wedege) resection for early stage lung cancer, including SLC and mi-SLC, especially MIA, showed a better outcome. Wedge resection is of first choice for these aged, sickly and weak patients, further, wedge resection might be enough for curing mi-SLC, eapecially those GGO MIA. Prospective observation is needed. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05)