Elsevier

Journal of Thoracic Oncology

Volume 7, Issue 10, October 2012, Pages 1563-1566
Journal of Thoracic Oncology

Original Articles
Long-Term Outcomes of 50 Cases of Limited-Resection Trial for Pulmonary Ground-Glass Opacity Nodules

https://doi.org/10.1097/JTO.0b013e3182641b5cGet rights and content
Under an Elsevier user license
open archive

Introduction

From 1998 to 2002, we performed a trial of prospective limited resection for pulmonary ground-glass opacity lesions 2 cm or smaller. This is the second report on the long-term outcome.

Methods

The enrollment criteria of the trial were as follows: pulmonary peripheral nodule less than 2 cm, diagnosis or suspected diagnosis of clinical T1N0M0 carcinoma with ground-glass opacity and lack of evident pleural indentations or vascular convergence on high-resolution computed tomography. Limited-resection (wedge or segment) specimens were intraoperatively examined by frozen section. If the nodule was confirmed as Noguchi type A or B with a resection margin of greater than 1 cm, the incision was sutured and the patient followed up. The median surveillance period was 10 years.

Results

In a total of 50 enrolled participants, there were two Noguchi type A, 23 type B and 15 type C adenocarcinomas; five atypical adenomatous hyperplasias, four fibroses, and one granuloma. Although there were no patients with recurrence within the first 5 years, in four patients who underwent limited-resection pulmonary adenocarcinoma developed more than 5 years after the initial resection, of either cut-end recurrence or metachronous primary disease.

Conclusions

Of 26 patients who underwent limited resection, adenocarcinoma developed in four after more than 5 years. These were possibly cut-end recurrences. We concluded that 5 years is not a sufficient period for follow-up, and that limited resection should still be done only in a trial setting, even for small ground-glass opacity lesions.

Key Words

Lung cancer
Adenocarcinoma
Limited resection
Ground-glass opacity
Noguchi classification

Cited by (0)

Disclosure: The authors declare no conflicts of interest.