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The oncological outcomes of segmentectomy in clinical-T1b lung adenocarcinoma with a solid-dominant appearance on thin-section computed tomography

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Abstract

Purpose

We investigated the surgical outcomes of clinical-T1b lung adenocarcinomas patients whose tumors had a solid-dominant radiological appearance and who were treated with segmentectomy or lobectomy.

Methods

We examined 154 surgically resected clinical-T1b lung adenocarcinomas with a “solid-dominant” appearance on thin-section computed tomography (CT). The preoperative thin-section CT images of all cases were reviewed. “Solid-dominant” was defined as 0.5≤ consolidation/tumor ratio (CTR) <1.0.

Results

Pathological nodal metastasis, lymphatic invasion, vascular invasion, and pleural invasion were found in 7 (4.5 %), 27 (18 %), 21 (14 %), and 15 (10 %) patients with clinical-T1b solid-dominant lung adenocarcinoma, respectively. Lobectomy and segmentectomy were performed in 123 (80 %) and 31 (20 %) cases, respectively. The 3-year overall survival (OS) and relapse-free survival (RFS) of patients with clinical-T1b solid-dominant lung adenocarcinoma were 95.5 and 92.4 %, respectively. The 3-year RFS and OS did not differ significantly between the patients who underwent lobectomy or segmentectomy (3-year RFS, 92.3 vs. 93.4 %, p = 0.8713; 3-year OS, 95.3 vs. 96.6 %, p = 0.7603). Segmentectomy was not found to be a prognostic factor for RFS (p = 0.8714), or OS (p = 0.7613).

Conclusions

Segmentectomy can achieve acceptable oncological outcomes (both in terms of OS and RFS), which are similar to those achieved with standard lobectomy, in patients with clinical-T1b solid-dominant lung adenocarcinoma.

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Abbreviations

CT:

Computed tomography

GGO:

Ground-glass opacity

NSCLC:

Non-small cell lung cancer

PET:

Positron emission tomography

SUVmax:

Maximum standardized uptake value

18F-FDG:

18F-fluorodeoxyglucose

CTR:

Consolidation/tumor ratio

OS:

Overall survival

RFS:

Relapse-free survival

CEA:

Carcinoembryonic antigen

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Acknowledgments

This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare, Japan, the Smoking Research Foundation, and the National Cancer Center Research and Development Fund (26-A-4).

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan

    Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh & Kenji Suzuki

Authors
  1. Aritoshi Hattori
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  2. Takeshi Matsunaga
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  3. Kazuya Takamochi
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  4. Shiaki Oh
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  5. Kenji Suzuki
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Corresponding author

Correspondence to Kenji Suzuki.

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The authors declare no conflicts of interest in association with the present study.

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Hattori, A., Matsunaga, T., Takamochi, K. et al. The oncological outcomes of segmentectomy in clinical-T1b lung adenocarcinoma with a solid-dominant appearance on thin-section computed tomography. Surg Today 46, 914–921 (2016). https://doi.org/10.1007/s00595-015-1256-6

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  • DOI: https://doi.org/10.1007/s00595-015-1256-6

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