Clinical outcome of resected solid-type small-sized c-stage IA non-small cell lung cancer
Clinical outcome of resected solid-type small-sized c-stage IA non-small cell lung cancer
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DOI：
10.1016/j.ejcts.2009.12.030
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发表时间：
2010-06-01
影响因子：
3.4
通讯作者：
Okumura, Meinoshin
中科院分区：
文献类型：
--
作者：
Inoue, Masayoshi;Minami, Masato;Okumura, Meinoshin
背景资料：由于薄层计算机断层扫描（CT）的发展，小肺癌的肺切除机会增加了。尽管肺叶切除术可用于毛玻璃样阴影（GGO）为主的腺癌，但其恶性潜能尚未得到充分评估。我们的目的是解决小于2 cm的实体型C期IA非小细胞肺癌（NSCLC）切除术的临床结局。研究方法：回顾性观察118例CT显示实性成分大于50%的小于2cm肺癌患者的术后生存和复发情况。结果：35例实性成分占主导地位的病变（SCDL）和83例单纯实性病变（PSL）无GGO。淋巴结转移15例（18%）。SDCL患者的5年无病生存率（DES）为100%，PSL患者为83%。多因素分析显示，淋巴结转移和胸膜侵犯是PSL患者独立的预后负性预测因素。p-NO、p-N1和p-N2患者的5年DES分别为88%、80%和46%。胸膜受累患者的5年DES为33%，显著差于无胸膜受累患者。术后3年内复发主要为胸内病灶。结论：一部分实体型NSCLC具有恶性潜能，即使肿瘤小于2 cm。完全切除后需要定期进行胸内评估。(C)2010年欧洲胸外科协会。Elsevier B. V.出版，保留所有权利。
Background: The chances of pulmonary resection for small-sized lung cancer have increased because of the development of thin-slice computed tomography (CT). Though sublobar resection could be indicated for ground glass opacity (GGO)-dominant adenocarcinoma with low-grade behaviour, the malignant potential of solid-type, small-sized lung cancer has not been sufficiently assessed. We aimed to address the clinical outcomes of resected solid-type c-stage IA non-small cell lung cancer (NSCLC) smaller than 2 cm. Methods: A retrospective observational study involving 118 patients who had undergone a complete resection for lung cancer smaller than 2 cm with solid component more than 50% on CT was conducted, and their postoperative survival and recurrence pattern were analysed. Results: Thirty-five patients with solid component-dominant lesion (SCDL) and 83 patients with pure solid lesion (PSL) without GGO were enrolled. Lymph node involvement was found in 15 patients with PSL (18%). The 5-year disease-free survival (DES) was 100% in SDCL patients and 83% in PSL patients. Multivariate analysis of PSL patients showed that lymph node metastasis and pleural invasion were independent negative prognostic predictors. The 5-year DES was 88%, 80% and 46% in p-NO, p-N1 and p-N2 patients, respectively. The 5-year DES was 33% for patients with pleural invasion, which was significantly worse than that for patients without pleural involvement. Postoperative recurrence was mainly observed as intrathoracic lesions within 3 years. Conclusions: A proportion of solid-type NSCLC has malignant potential, even for tumours smaller than 2 cm. Periodic intrathoracic evaluation is required following complete resection. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.