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Prognosis After Sublobar Resection of Small-sized Non-small Cell Lung Cancer with Visceral Pleural or Lymphovascular Invasion

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Abstract

Background

Although standard surgical treatment of stage I non-small cell lung cancer (NSCLC) is lobectomy, sublobar resection may be elected for small-sized (≤2 cm) peripheral tumors. Our aim was examine the need for completion lobectomy in the event of confirmed pleural or lymphovascular invasion after sublobar resection of NSCLC.

Methods

A total of 271 consecutive patients undergoing curative resection of stage I NSCLC ≤2 cm were reviewed retrospectively, analyzing clinicopathologic findings and survival times of those with invasion-positive (visceral pleural or lymphovascular invasion) or invasion-negative (neither visceral pleural nor lymphovascular invasion) tumors by surgical approach (sublobar resection vs lobectomy).

Results

Aside from age and pulmonary function, clinicopathologic characteristics of the patient subsets did not differ significantly, nor did 5-year recurrence-free survival rates of surgical subsets (sublobar resection vs lobectomy) in respective tumor groups (invasion-positive 78.9 vs 79.8%, p = 0.928; invasion-negative 80.2 vs 85.4%, p = 0.505). In multivariate analysis, dissected lymph node count was the sole parameter significantly impacting recurrence of stage I invasion-positive NSCLC (hazard ratio = 0.914, 95% confidence interval 0.845–0.988; p = 0.023). Sublobar resection was not a risk factor for recurrence.

Conclusions

Survival rates for patients with small-sized (≤2 cm) NSCLC and visceral pleural or lymphovascular invasion did not differ significantly, whether sublobar resection or lobectomy was done. Hence, completion lobectomy is unnecessary in this setting.

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References

  1. Ginsberg RJ, Rubinstein LV (1995) Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group Ann Thorac Surg 60:615–622 discussion 622–613

    Article  CAS  Google Scholar 

  2. Moon Y, Sung SW, Moon SW et al (2016) Risk factors for recurrence after sublobar resection in patients with small (2 cm or less) non-small cell lung cancer presenting as a solid-predominant tumor on chest computed tomography. J Thorac Dis 8:2018–2026

    Article  PubMed  PubMed Central  Google Scholar 

  3. Okada M, Koike T, Higashiyama M et al (2006) Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg 132:769–775

    Article  PubMed  Google Scholar 

  4. Koike T, Kitahara A, Sato S et al (2016) Lobectomy Versus Segmentectomy in Radiologically Pure Solid Small-Sized Non-Small Cell Lung Cancer. Ann Thorac Surg 101:1354–1360

    Article  PubMed  Google Scholar 

  5. Cao C, Chandrakumar D, Gupta S et al (2015) Could less be more?-A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer 89:121–132

    Article  PubMed  Google Scholar 

  6. Blasberg JD, Pass HI, Donington JS (2010) Sublobar resection: a movement from the Lung Cancer Study Group. J Thorac Oncol 5:1583–1593

    Article  PubMed  Google Scholar 

  7. 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 40:271–274

    Article  PubMed  Google Scholar 

  8. Hung JJ, Jeng WJ, Hsu WH et al (2012) Predictors of death, local recurrence, and distant metastasis in completely resected pathological stage-I non-small-cell lung cancer. J Thorac Oncol 7:1115–1123

    Article  PubMed  Google Scholar 

  9. Park C, Lee IJ, Jang SH et al (2014) Factors affecting tumor recurrence after curative surgery for NSCLC: impacts of lymphovascular invasion on early tumor recurrence. J Thorac Dis 6:1420–1428

    PubMed  PubMed Central  Google Scholar 

  10. Mimae T, Tsutani Y, Miyata Y et al (2014) Role of lymphatic invasion in the prognosis of patients with clinical node-negative and pathologic node-positive lung adenocarcinoma. J Thorac Cardiovasc Surg 147:1820–1826

    Article  PubMed  Google Scholar 

  11. Kuo SW, Chen JS, Huang PM et al (2014) Prognostic significance of histologic differentiation, carcinoembryonic antigen value, and lymphovascular invasion in stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 148(1200–1207):e1203

    Google Scholar 

  12. Mollberg NM, Bennette C, Howell E et al (2014) Lymphovascular invasion as a prognostic indicator in stage I non-small cell lung cancer: a systematic review and meta-analysis. Ann Thorac Surg 97:965–971

    Article  PubMed  Google Scholar 

  13. Lu P, Sun Y, Sun Y et al (2014) The role of (18)F-FDG PET/CT for evaluation of metastatic mediastinal lymph nodes in patients with lung squamous-cell carcinoma or adenocarcinoma. Lung Cancer 85:53–58

    Article  PubMed  Google Scholar 

  14. Moon Y, Kim KS, Lee KY et al (2016) Clinicopathologic Factors Associated With Occult Lymph Node Metastasis in Patients With Clinically Diagnosed N0 Lung Adenocarcinoma. Ann Thorac Surg 101:1928–1935

    Article  PubMed  Google Scholar 

  15. Edge SB, Byrd DR, Compton CC et al (2010) AJCC cancer staging manual. Springer, New York

    Google Scholar 

  16. Taioli E, Yip R, Olkin I et al (2016) Survival after sublobar resection for early-stage lung cancer: methodological obstacles in comparing the efficacy to lobectomy. J Thorac Oncol 11:400–406

    Article  PubMed  Google Scholar 

  17. Tao H, Hayashi T, Sano F et al (2013) Prognostic impact of lymphovascular invasion compared with that of visceral pleural invasion in patients with pN0 non-small-cell lung cancer and a tumor diameter of 2 cm or smaller. J Surg Res 185:250–254

    Article  PubMed  Google Scholar 

  18. Moon Y, Sung SW, Namkoong M et al (2016) The effectiveness of mediastinal lymph node evaluation in a patient with ground glass opacity tumor. J Thorac Dis 8:2617–2625

    Article  PubMed  PubMed Central  Google Scholar 

  19. De Leyn P, Dooms C, Kuzdzal J et al (2014) Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg 45:787–798

    Article  PubMed  Google Scholar 

  20. Heineman DJ, Ten Berge MG, Daniels JM et al (2016) Clinical Staging of Stage I Non-Small Cell Lung Cancer in the Netherlands-Need for Improvement in an Era with Expanding Nonsurgical Treatment Options: Data From the Dutch Lung Surgery Audit. Ann Thorac Surg 102:1615–1621

    Article  PubMed  Google Scholar 

  21. Altorki NK, Kamel MK, Narula N et al (2016) Anatomical Segmentectomy and Wedge Resections Are Associated with Comparable Outcomes for Patients with Small cT1N0 Non-Small Cell Lung Cancer. J Thorac Oncol 11:1984–1992

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

No specific grants from public, commercial, or nonprofit agencies funded this research. A native English-speaking professional (BioMed Proofreading, LLC) refined the written content.

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Youngkyu Moon & Jae Kil Park

  2. Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Kyo Young Lee

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  1. Youngkyu Moon
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Correspondence to Youngkyu Moon.

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Moon, Y., Lee, K.Y. & Park, J.K. Prognosis After Sublobar Resection of Small-sized Non-small Cell Lung Cancer with Visceral Pleural or Lymphovascular Invasion. World J Surg 41, 2769–2777 (2017). https://doi.org/10.1007/s00268-017-4075-7

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  • DOI: https://doi.org/10.1007/s00268-017-4075-7

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