The Outcomes of a Limited Resection for Non-Small Cell Lung Cancer Based on Differences in Pathology

被引：21

作者：

Yano, Motoki ^{[1
]}

Yoshida, Junji ^{[2
]}

Koike, Terumoto ^{[3
]}

Kameyama, Kotaro ^{[4
]}

Shimamoto, Akira ^{[5
]}

Nishio, Wataru ^{[6
]}

Yoshimoto, Kentaro ^{[7
]}

Utsumi, Tomoki ^{[8
]}

Shiina, Takayuki ^{[9
]}

Watanabe, Atsushi ^{[10
]}

Yamato, Yasushi ^{[11
]}

Watanabe, Takehiro ^{[12
]}

Takahashi, Yusuke ^{[13
]}

Sonobe, Makoto ^{[14
]}

Kuroda, Hiroaki ^{[15
]}

Oda, Makoto ^{[16
]}

Inoue, Masayoshi ^{[17
]}

Tanahashi, Masayuki ^{[18
]}

Adachi, Hirofumi ^{[19
]}

Saito, Masao ^{[20
]}

Hayashi, Masataro ^{[21
]}

Otsuka, Hajime ^{[22
]}

Mizobuchi, Teruaki ^{[23
]}

Moriya, Yasumitsu ^{[24
]}

Takahashi, Mamoru ^{[25
]}

Nishikawa, Shigeto ^{[26
]}

Matsumura, Yuki ^{[2
,27
]}

Moriyama, Satoru ^{[1
]}

Fujii, Yoshitaka ^{[1
]}

机构：

[1] Nagoya City Univ, Grad Sch Med Sci, Dept Oncol Immunol & Surg, Mizuho Ku, 1 Kawasumi,Mizuho Cho, Nagoya, Aichi, Japan

[2] Natl Canc Ctr Hosp East, Div Thorac Surg, Chiba, Japan

[3] Niigata Univ, Grad Sch Med & Dent Sci, Dept Thorac & Cardiovasc Surg, Niigata, Japan

[4] Kurashiki Cent Hosp, Dept Thorac Surg, Kurashiki, Okayama, Japan

[5] Mie Univ, Dept Thorac & Cardiovasc Surg, Grad Sch Med, Tsu, Mie, Japan

[6] Kobe Med Ctr, Dept Gen Thorac Surg, Natl Hosp Org, Kobe, Hyogo, Japan

[7] Kumamoto Univ, Grad Sch Med Sci, Dept Thorac Surg, Kumamoto, Japan

[8] Kinki Chuo Chest Med Ctr, Dept Surg, Natl Hosp Org, Sakai, Osaka, Japan

[9] Shinshu Univ, Dept Thorac Surg, Sch Med, Matsumoto, Nagano, Japan

[10] Sapporo Med Univ, Sch Med, Dept Thorac & Cardiovasc Surg, Sapporo, Hokkaido, Japan

[11] Nagaoka Red Cross Hosp, Dept Thorac Surg, Nagaoka, Niigata, Japan

[12] Nishi Niigata Chuo Natl Hosp, Dept Thorac Surg, Natl Hosp Org, Niigata, Japan

[13] Teikyo Univ, Dept Surg, Sch Med, Tokyo, Japan

[14] Kyoto Univ Hosp, Dept Thorac Surg, Kyoto, Japan

[15] Aichi Canc Ctr Hosp, Dept Thorac Surg, Nagoya, Aichi, Japan

[16] Kanazawa Univ, Dept Gen & Cardiothorac Surg, Kanazawa, Ishikawa, Japan

[17] Kyoto Prefectural Univ Med, Div Thorac Surg, Dept Surg, Kyoto, Japan

[18] Seirei Mikatahara Gen Hosp, Div Thorac Surg, Resp Dis Ctr, Hamamatsu, Shizuoka, Japan

[19] Hokkaido Canc Ctr, Dept Thorac Surg, Sapporo, Hokkaido, Japan

[20] Tenri Hosp, Dept Thorac Surg, Nara, Japan

[21] Yamaguchi Univ, Div Chest Surg, Dept Surg & Clin Sci, Grad Sch Med, Ube, Yamaguchi, Japan

[22] Toho Univ, Dept Chest Surg, Omori Med Ctr, Tokyo, Japan

[23] Chiba Univ, Dept Gen Thorac Surg, Grad Sch Med, Chiba, Japan

[24] Chiba Canc Ctr, Div Thorac Surg, Chiba, Japan

[25] Fukui Red Cross Hosp, Dept Chest Surg, Fukui, Japan

[26] Shizuoka City Shizuoka Hosp, Div Thorac Surg, Shizuoka, Japan

[27] Fukushima Med Univ, Div Chest Surg, Fukushima, Japan

来源：

WORLD JOURNAL OF SURGERY | 2016年 / 40卷 / 11期

关键词：

NEUROENDOCRINE CARCINOMA; SUBLOBAR RESECTION; TUMOR SIZE; SURVIVAL; LOBECTOMY; ADENOCARCINOMA; CLASSIFICATION; PROGNOSIS; TRIAL; NODE;

D O I：

10.1007/s00268-016-3596-9

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

A precise preoperative diagnosis of in situ or minimally invasive carcinoma may identify patients who can be treated by limited resection. Although some clinical trials of limited resection for lung cancer have started, it will take a long time before the results will be published. We have already reported a large-scale study of limited resection. We herein report the data for a subclass analysis according to differences in pathology. Data from multiple institutions were collected on 1710 patients who had undergone limited resection (segmentectomy or wedge resection) for cT1N0M0 non-small cell carcinoma. The disease-free survival (DFS) and recurrence-free proportion (RFP) were analyzed. Small cell carcinomas and carcinoid tumors were excluded from this analysis. Adenocarcinomas were sub-classified into four groups using two factors, the ratio of consolidation to the tumor diameter (C/T) and the tumor diameter alone. The median patient age was 64 (20-75) years old. The mean maximal diameter of the tumors was 1.5 +/- 0.5 cm. The DFS and RFP at 5 years based on the pathology were 92.2 and 94.7 % in adenocarcinoma (n = 1575), 76.3 and 82.4 % in squamous cell carcinoma (SqCC) (n = 100), and 73.6 and 75.9 % in patients with other tumors (n = 35). The prognosis of adenocarcinoma in both groups A (C/T aecurrency sign0.25 and tumor diameter aecurrency sign2.0 cm) and B (C/T aecurrency sign0.25 and tumor diameter > 2.0 cm) was good. In SqCC, only segmentectomy was a favorable prognostic factor. In the groups with other pathologies, large cell carcinomas were worse in prognosis (the both DFS and RFP: 46.3 %). Knowing the pathological diagnosis is important to determine the indications for limited resection. Measurement of the tumor diameter and C/T was useful to determine the indications for limited resection for adenocarcinoma. Limited resection for adenocarcinomas is similar with a larger resection, while the technique should be performed with caution in squamous cell carcinoma and other pathologies.

引用

页码：2688 / 2697

页数：10

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