World Journal of Surgery

, Volume 41, Issue 2, pp 472–479 | Cite as

Sublobar Resection Margin Width Does Not Affect Recurrence of Clinical N0 Non-small Cell Lung Cancer Presenting as GGO-Predominant Nodule of 3 cm or Less

  • Youngkyu Moon
  • Kyo Young Lee
  • Seok Whan Moon
  • Jae Kil Park
Original Scientific Report



Sublobar resection of lung cancer may benefit patients with lung cancer presenting as ground-glass opacity (GGO) nodules. The purpose of this study was to evaluate the effect of margin width on recurrence after sublobar resection in patients with clinical N0 non-small cell lung cancer presenting as GGO-predominant nodule.


We conducted a retrospective chart review of 91 patients treated for clinical N0 non-small cell lung cancer ≤3 cm by sublobar resection with clear resection margins. We assigned them to two groups: GGO-predominant tumor and solid-predominant tumor. Each group was subdivided into two groups according to the margin width: resection margin ≤5 mm and resection margin >5 mm. We analyzed the clinicopathological findings and survival among these four groups.


There was no recurrence in GGO-predominant tumors after sublobar resection. Margin width did not influence the recurrence in GGO-predominant tumors. In the cases of solid-predominant tumor, 5-year recurrence-free survival after sublobar resection according to margin width ≤5 and >5 mm was 24.2 and 79.6 %, respectively (p < 0.001). Therefore, narrow margin width (resection margin ≤5 mm) was a significant risk factor for recurrence of solid-predominant tumors (hazard ratio 3.868, 95 % confidence interval 1.177–12.714, p = 0.026).


The width between the tumor and resection margin does not affect the recurrence after R0 sublobar resection in patients with clinical N0 GGO-predominant lung cancer ≤3 cm. By contrast, margin width is a significant risk factor for recurrence after sublobar resection in patients with clinical N0 solid-predominant lung cancer.


Resection Margin National Comprehensive Cancer Network National Comprehensive Cancer Network Wedge Resection Margin Width 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This research was not supported by outside funds.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.


  1. 1.
    Torre LA, Siegel RL, Jemal A (2016) Lung cancer statistics. Adv Exp Med Biol 893:1–19CrossRefPubMedGoogle Scholar
  2. 2.
    Kim HY, Shim YM, Lee KS et al (2007) Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons. Radiology 245:267–275CrossRefPubMedGoogle Scholar
  3. 3.
    Yoshida J, Nagai K, Yokose T et al (2005) Limited resection trial for pulmonary ground-glass opacity nodules: fifty-case experience. J Thorac Cardiovasc Surg 129:991–996CrossRefPubMedGoogle Scholar
  4. 4.
    Cho JH, Choi YS, Kim J et al (2015) Long-term outcomes of wedge resection for pulmonary ground-glass opacity nodules. Ann Thorac Surg 99:218–222CrossRefPubMedGoogle Scholar
  5. 5.
    Eguchi T, Kadota K, Park BJ et al (2014) The new IASLC–ATS–ERS lung adenocarcinoma classification: what the Surgeon Should Know. Semin Thorac Cardiovasc Surg 26:210–222CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Nakamura K, Saji H, Nakajima R et al (2010) A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol 40:271–274CrossRefPubMedGoogle Scholar
  7. 7.
    Sawabata N, Ohta M, Matsumura A et al (2004) Optimal distance of malignant negative margin in excision of nonsmall cell lung cancer: a multicenter prospective study. Ann Thorac Surg 77:415–420CrossRefPubMedGoogle Scholar
  8. 8.
    Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRefPubMedGoogle Scholar
  9. 9.
    Goldstein NS, Ferkowicz M, Kestin L et al (2003) Wedge resection margin distances and residual adenocarcinoma in lobectomy specimens. Am J Clin Pathol 120:720–724CrossRefPubMedGoogle Scholar
  10. 10.
    Travis WD, Brambilla E, Nicholson AG et al (2015) The 2015 world health organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol 10:1243–1260CrossRefPubMedGoogle Scholar
  11. 11.
    Nitadori J, Bograd AJ, Kadota K et al (2013) Impact of micropapillary histologic subtype in selecting limited resection vs lobectomy for lung adenocarcinoma of 2 cm or smaller. J Natl Cancer Inst 105:1212–1220CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Zhang Y, Wang R, Cai D et al (2014) A comprehensive investigation of molecular features and prognosis of lung adenocarcinoma with micropapillary component. J Thorac Oncol 9:1772–1778CrossRefPubMedGoogle Scholar
  13. 13.
    Yanagawa N, Shiono S, Abiko M et al (2014) The correlation of the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification with prognosis and EGFR mutation in lung adenocarcinoma. Ann Thorac Surg 98:453–458CrossRefPubMedGoogle Scholar
  14. 14.
    Zhang J, Liang Z, Gao J et al (2011) Pulmonary adenocarcinoma with a micropapillary pattern: a clinicopathological, immunophenotypic and molecular analysis. Histopathology 59:1204–1214CrossRefPubMedGoogle Scholar
  15. 15.
    Wilshire CL, Louie BE, Manning KA et al (2015) Radiologic evaluation of small lepidic adenocarcinomas to guide decision making in surgical resection. Ann Thorac Surg 100:979–988CrossRefPubMedGoogle Scholar
  16. 16.
    Cho H, Lee HY, Kim J et al (2015) Pure ground glass nodular adenocarcinomas: are preoperative positron emission tomography/computed tomography and brain magnetic resonance imaging useful or necessary? J Thorac Cardiovasc Surg 150:514–520CrossRefPubMedGoogle Scholar
  17. 17.
    Duann CW, Hung JJ, Hsu PK et al (2013) Surgical outcomes in lung cancer presenting as ground-glass opacities of 3 cm or less: a review of 5 years’ experience. J Chin Med Assoc 76:693–697CrossRefPubMedGoogle Scholar
  18. 18.
    Sim HJ, Choi SH, Chae EJ et al (2014) Surgical management of pulmonary adenocarcinoma presenting as a pure ground-glass nodule. Eur J Cardiothorac Surg 46:632–636 (discussion 636) CrossRefPubMedGoogle Scholar
  19. 19.
    Lim HJ, Ahn S, Lee KS et al (2013) Persistent pure ground-glass opacity lung nodules ≥10 mm in diameter at CT scan: histopathologic comparisons and prognostic implications. Chest 144:1291–1299CrossRefPubMedGoogle Scholar
  20. 20.
    Sasada S, Nakayama H, Miyata Y et al (2015) Comparison of malignant grade between pure and partially invasive types of early lung adenocarcinoma. Ann Thorac Surg 99:956–960CrossRefPubMedGoogle Scholar
  21. 21.
    Suzuki K, Kusumoto M, Watanabe S et al (2006) Radiologic classification of small adenocarcinoma of the lung: radiologic–pathologic correlation and its prognostic impact. Ann Thorac Surg 81:413–419CrossRefPubMedGoogle Scholar
  22. 22.
    Kirmani BH, Rintoul RC, Win T et al (2013) Stage migration: results of lymph node dissection in the era of modern imaging and invasive staging for lung cancer. Eur J Cardiothorac Surg 43:104–109 (discussion 109–110) CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Youngkyu Moon
    • 1
  • Kyo Young Lee
    • 2
  • Seok Whan Moon
    • 1
  • Jae Kil Park
    • 1
  1. 1.Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  2. 2.Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea

Personalised recommendations