Volume 73, Issue 6 , Pages 308-313, June 2010
Surgical Outcomes in Resected Non-small Cell Lung Cancer ≤ 1 cm in Diameter
Article Outline
Background
The goal of this study was to investigate the prognostic factors and patterns of recurrence in patients with resected non-small cell lung cancer (NSCLC) ≤ 1 cm in diameter.
Methods
We conducted a retrospective review of the clinicopathological characteristics of 71 patients with NSCLC ≤ 1 cm in diameter in Taipei Veterans General Hospital between 1982 and 2007. Overall survival and its predictors were analyzed.
Results
Median follow-up time of the 71 patients was 33.3 months. Complete resection was performed in 68 patients (95.8%) with stage I disease. The 5- and 10-year overall survival rates of patients who underwent complete resections were 81.7% and 44.9%, respectively. There was tumor recurrence in 6 (8.8%) of these 68 patients. Five (9.3%) of 54 patients who underwent standard resection experienced tumor recurrence, but only 1 (7.1%) of 14 patients who received sublobar resection had recurrent disease. The difference was not statistically significant (p = 0.569). Multivariate analysis revealed that sublobar resection (hazard ratio, 5.00; 95% confidence interval, 1.28–20.00; p = 0.020) was a significant predictor for worse overall survival.
Conclusion
Survival in patients with NSCLC £ 1 cm in diameter is satisfactory. Sublobar resection, performed in patients unfit for standard resection, is a poor prognostic factor for overall survival.
Key Words: non-small cell lung cancer , predictor , subcentimeter , sublobar resection , survival
No full text is available. To read the body of this article, please view the PDF online.
References
- Annual Report of the Department of Health, Executive Yuan, Republic of China, 2007.
- . Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomized clinical trials . BMJ . 1995;311:899–909
- . Revisions in the international system for staging lung cancer . Chest . 1997;111:1710–1717
- . Stage I non-small cell lung cancer: a multivariate analysis of treatment methods and patterns of recurrence . Cancer . 1995;76:787–796
- . Survival in early-stage non-small cell lung cancer . Ann Thorac Surg . 1995;60:466–472
- . Survival of patients with stage I lung cancer detected on CT screening . N Engl J Med . 2006;355:1763–1771
- . Computed tomography screening and lung cancer outcomes . JAMA . 2007;297:953–961
- . Surgical treatment of non-small cell lung cancer 1 cm or less in diameter . Ann Thorac Surg . 2002;73:1545–1550
- . Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group . Ann Thorac Surg . 1995;60:615–622
- . Lobectomy versus limited resection in T1N0 lung cancer . Ann Thorac Surg . 1996;62:1249–1250
- Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis . Ann Thorac Surg . 2006;82:408–416
- . Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller? . Ann Thorac Surg . 2001;71:956–961
- . Intentional limited pulmonary resection for peripheral T1N0M0 small-sized lung cancer . J Thorac Cardiovasc Surg . 2003;125:924–928
- . Frequency of local recurrence following segmentectomy of stage IA non-small cell lung cancer is influenced by segment localisation and width of resection margins: implications for patient selection for segmentectomy . Eur J Cardiothorac Surg . 2007;31:522–528
- . Histological Typing of Lung Tumors . 2nd edition. Geneva: World Health Organization; 1981;
- . International Union Against Cancer: TNM Classification of Malignant Tumours . 5th edition. New York: Wiley-Liss; 1997;
- . Nonparametric estimation for incomplete observations . J Am Stat Assoc . 1958;53:457–481
- . Tumor size predicts survival within stage IA non-small cell lung cancer . Chest . 2003;124:1828–1833
- . Survival after pathological stage IA nonsmall cell lung cancer: tumor size matters . Ann Thorac Surg . 2005;79:1137–1141
- . Staging in lung cancer: is 3 cm a prognostic threshold in pathologic stage I non-small cell lung cancer? A multicenter study of 1,020 patients . Chest . 2002;121:1515–1520
- . Tumor size does not have prognostic significance in stage Ia NSCLC . Anticancer Res . 2000;20:1155–1158
- . Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer . Chest . 2000;117:1568–1571
- . Peripheral lung adenocarcinomas: 10 mm or less in diameter . Ann Thorac Surg . 2003;76:350–355
- . Long-term survival and recurrence in patients with resected non-small cell lung cancer 1 cm or less in size . J Thorac Cardiovasc Surg . 2006;132:1382–1389
- . Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small cell lung carcinomas: are these carcinomas candidates for video-assisted lobectomy? . J Thorac Cardiovasc Surg . 1996;111:1125–1134
- . Extent of mediastinal node metastasis in clinical stage I non-small-cell lung cancer: the role of systemic nodal dissection . Lung Cancer . 1998;22:23–30
- . Strategy for lymphadenectomy in lung cancer three centimeters or less in diameter . Ann Thorac Surg . 1990;50:708–713
- Peripheral non-small cell lung cancers 2.0 cm or less in diameter: proposed criteria for limited pulmonary resection based upon clinicopathological presentation . Lung Cancer . 1998;21:185–191
- . Long-term results of pathological stage I non-small cell lung cancer: validation of using the number of totally removed lymph nodes as a staging control . Eur J Cardiothorac Surg . 2003;24:994–1001
- . Prognostic factors in resected stage I non-small cell lung cancer with a diameter of 3 cm or less: visceral pleural invasion did not influence overall and disease-free survival . J Thorac Cardiovasc Surg . 2007;134:638–643
PII: S1726-4901(10)70066-6
doi:10.1016/S1726-4901(10)70066-6
© 2010 Elsevier. Published by Elsevier Inc. All rights reserved.
Volume 73, Issue 6 , Pages 308-313, June 2010
