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General Thoracic and Cardiovascular Surgery

, Volume 65, Issue 10, pp 581–586 | Cite as

Surgical outcome of wide wedge resection in poor-risk patients with clinical-N0 non-small cell lung cancer

  • Hiroaki TsunezukaEmail author
  • Daishiro Kato
  • Satoru Okada
  • Tatsuo Furuya
  • Junichi Shimada
  • Masayoshi Inoue
Original Article
  • 393 Downloads

Abstract

Objective

Sublobar resection is practically indicated in poor-risk patients compromised cardiopulmonary reserve or for small ground-glass opacity-dominant adenocarcinomas. The aim of this study was to clarify the surgical outcomes of wide wedge resection in poor-risk patients with clinical-N0 non-small cell lung cancers.

Methods

Sixty-two poor-risk patients, who underwent wedge resection for clinical-N0 lung cancer, were retrospectively reviewed. We defined the ratio of the maximum diameter of the consolidation to the maximum tumour diameter as the consolidation-to-tumour ratio using high-resolution computed tomography.

Results

The 5-year overall, recurrence-free, and lung cancer specific survivals of all patients were 56.4, 46.6, and 81.1%, respectively, while other malignancies were frequently found as causes of death. Overall and recurrence-free survivals were favourable in patients with tumour size ≤3 cm, consolidation-to-tumour ratio ≤0.50, solid tumour size ≤1.2 cm, carcinoembryonic antigen level <5.0 ng/mL and adenocarcinoma. Multivariate Cox proportional hazard model revealed that solid tumour size ≤1.2 cm and consolidation-to-tumour ratio ≤0.50 were independent prognostic factors. CT-guided lipiodol marking was applied in 20 patients to identify the tumour location had no recurrence.

Conclusions

Wide wedge resection could be radical treatment option in poor-risk patients with clinical-N0 non-small cell lung cancer, though careful follow-up might be necessary for other malignancies. Patients with solid tumour ≤1.2 cm or ground-glass-dominant lesion are good candidates for wedge resection. CT-guided lipiodol marking is a useful option to identify the location and safe surgical tumour margin in wedge resection.

Keywords

Wide wedge resection Non-small cell lung cancer Consolidation-to-tumour ratio Solid tumour size Poor-risk patients Lipiodol marking 

Notes

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Supplementary material

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Supplementary material 1 (TIFF 210 kb)
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Supplementary material 2 (TIFF 164 kb)
11748_2017_803_MOESM3_ESM.docx (23 kb)
Supplementary material 3 (DOCX 23 kb)

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Copyright information

© The Japanese Association for Thoracic Surgery 2017

Authors and Affiliations

  1. 1.Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan

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