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Volume 73, Issue 6, Pages 308-313 (June 2010)


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Surgical Outcomes in Resected Non-small Cell Lung Cancer ≤ 1 cm in Diameter

Bing-Yen Wanga, Jung-Jyh Hungabc, Wen-Juei Jengd, Wen-Hu Hsua, Chih-Cheng Hsieha, Min-Hsiung Huanga, Biing-Shiun Huanga, Jung-Sen Liub, Yu-Chung WuaCorresponding Author Informationemail address

Received 25 January 2010; accepted 27 May 2010.

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.

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1. 1 Annual Report of the Department of Health, Executive Yuan, Republic of China, 2007.

2. 2 Non-Small Cell Lung Cancer Collaborative Group . 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 .

3. 3 Mountain CF . Revisions in the international system for staging lung cancer . Chest . 1997;111:1710–1717 . MEDLINE | CrossRef

4. 4 Harpole DH , Herndon JE , Young WG , Wolfe WG , Sabiston DC . Stage I non-small cell lung cancer: a multivariate analysis of treatment methods and patterns of recurrence . Cancer . 1995;76:787–796 .

5. 5 Nesbitt JC , Putnam JB , Walsh GL , Roth JA , Mountain JF . Survival in early-stage non-small cell lung cancer . Ann Thorac Surg . 1995;60:466–472 . MEDLINE | CrossRef

6. 6 Henschke CI , Yankelevitz DF , Libby DM , Pasmantier MW , Smith JP , Miettinen OS . Survival of patients with stage I lung cancer detected on CT screening . N Engl J Med . 2006;355:1763–1771 . CrossRef

7. 7 Bach PB , Jett JR , Pastorino U , Tockman MS , Swensen SJ , Begg CB . Computed tomography screening and lung cancer outcomes . JAMA . 2007;297:953–961 . CrossRef

8. 8 Miller DL , Rowland CM , Deschamps C , Allen MS , Trastek VF , Pairolero PC . Surgical treatment of non-small cell lung cancer 1 cm or less in diameter . Ann Thorac Surg . 2002;73:1545–1550 . MEDLINE | CrossRef

9. 9 Ginsberg RJ , Rubstein LV . 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 . MEDLINE | CrossRef

10. 10 Rubinstein LV , Ginsberg RJ . Lobectomy versus limited resection in T1N0 lung cancer . Ann Thorac Surg . 1996;62:1249–1250 . MEDLINE | CrossRef

11. 11 El-Sherif A, Gooding WE, Santos R, Pettiford B, Ferson PF, Fernando HC, et al  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 . CrossRef

12. 12 Okada M , Yoshikawa K , Hatta T , Tsubota N . 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 . MEDLINE | CrossRef

13. 13 Koike T , Yamato Y , Yoshiya K , Shimoyama T , Suzuki R . Intentional limited pulmonary resection for peripheral T1N0M0 small-sized lung cancer . J Thorac Cardiovasc Surg . 2003;125:924–928 . Abstract | Full Text | Full-Text PDF (71 KB) | CrossRef

14. 14 Sienel W, Stremmel C, Kirschbaum A, Hinterberger L, Stoelben E, Hasse J, et al. 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 . Abstract | Full Text | Full-Text PDF (238 KB) | CrossRef

15. 15 World Health Organization  . Histological Typing of Lung Tumors . 2nd edition. Geneva: World Health Organization; 1981; .

16. 16 Sobin LH , Wittekind C . International Union Against Cancer: TNM Classification of Malignant Tumours . 5th edition. New York: Wiley-Liss; 1997; .

17. 17 Kaplan EL , Meier P . Nonparametric estimation for incomplete observations . J Am Stat Assoc . 1958;53:457–481 .

18. 18 Port JL , Kent MS , Korst RJ . Tumor size predicts survival within stage IA non-small cell lung cancer . Chest . 2003;124:1828–1833 . MEDLINE | CrossRef

19. 19 Birim O , Kappetein P , Takkenberg JJM , Klaveren RJV , Bogers AJ . Survival after pathological stage IA nonsmall cell lung cancer: tumor size matters . Ann Thorac Surg . 2005;79:1137–1141 . CrossRef

20. 20 Lopez-Encuentra A , Duque-Medina JL , Rami-Porta R , Camara AG , Ferrando P . 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 . MEDLINE | CrossRef

21. 21 Yanagi S, Sugiura H, Morikawa T, Kaji M, Okushiba S, Kondo S, et al. Tumor size does not have prognostic significance in stage Ia NSCLC . Anticancer Res . 2000;20:1155–1158 . MEDLINE

22. 22 Patz EF , Rossi S , Harpole DH , Herndon JE , Goodman PC . Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer . Chest . 2000;117:1568–1571 . MEDLINE | CrossRef

23. 23 Kondo D , Yamada K , Kitayama Y , Hoshi S . Peripheral lung adenocarcinomas: 10 mm or less in diameter . Ann Thorac Surg . 2003;76:350–355 . MEDLINE | CrossRef

24. 24 Lee PC , Korst RJ , Port JL , Kerem Y , Kansler AL , Altorki NK . 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 . Abstract | Full Text | Full-Text PDF (129 KB) | CrossRef

25. 25 Asamura H , Nakayama H , Kondo H , Tsuchiya R , Shimosato Y , Naruke T . 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 . Abstract | Full Text | Full-Text PDF (765 KB) | CrossRef

26. 26 Oda M, Watanabe Y, Shimizu J, Murakami S, Ohta Y, Sekido N, et al. 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 . Abstract | Full Text | Full-Text PDF (101 KB) | CrossRef

27. 27 Ishida T , Yano T , Maeda K , Kaneko S , Tateishi M , Sugimachi K . Strategy for lymphadenectomy in lung cancer three centimeters or less in diameter . Ann Thorac Surg . 1990;50:708–713 . MEDLINE | CrossRef

28. 28 Konaka C, Ikeda N, Hiyoshi T, Tsuji K, Hirano T, Kawate N, et al  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 . Abstract | Full Text | Full-Text PDF (84 KB) | CrossRef

29. 29 Wu YC , Lin CF , Hsu WH , Huang BS , Huang MH , Wang LS . 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 . Abstract | Full Text | Full-Text PDF (190 KB) | CrossRef

30. 30 Hung JJ , Wang CY , Huang MH , Huang BS , Hsu WH , Wu YC . 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 . Abstract | Full Text | Full-Text PDF (407 KB) | CrossRef

a Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

b Division of Thoracic Surgery, Department of Surgery, Cathay General Hospital and Fu Jen Catholic University School of Medicine, Taipei, Taiwan, R.O.C.

c Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.

d Department of Internal Medicine, Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Taipei, Taiwan, R.O.C.

Corresponding Author InformationCorrespondence to: Dr Yu-Chung Wu, Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

 Bing-Yen Wang and Jung-Jyh Hung contributed equally to this work.

PII: S1726-4901(10)70066-6

doi:10.1016/S1726-4901(10)70066-6


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