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Peripheral lung adenocarcinomas: 10 mm or less in diameter
Daizo Kondo1, Katsuo Yamada, Yasuhiko Kitayama
1Department of General Thoracic Surgery, Shizuoka Saiseikai General Hospital, Shizuoka, Japan. d130893@siz.saiseikai.or.jp
The Annals of Thoracic Surgery
|August 7, 2003
Summary
Small peripheral lung adenocarcinomas (≤10 mm) are often non-invasive and have excellent survival rates. These early-stage lung cancers typically exhibit specific histopathologic features, favoring less invasive surgical approaches.
Area of Science:
- Oncology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Limited data exists on peripheral lung adenocarcinomas ≤10 mm.
- This size represents the smallest detectable by current diagnostic methods.
Purpose of the Study:
- To investigate the clinicopathologic features of small peripheral lung adenocarcinomas (≤10 mm).
- To compare outcomes of these small tumors with larger adenocarcinomas (11-20 mm).
Main Methods:
- Clinicopathologic study of 57 patients with lung adenocarcinomas ≤10 mm.
- Comparison with 32 patients (11-15 mm) and 35 patients (16-20 mm).
- All tumors were curatively resected between 1992 and 2002.
Main Results:
- Small adenocarcinomas were more frequent in females (78.9%) and non-smokers (77.2%).
- 96.5% were detected by CT scan, often with negative chest radiography.
- High rate of non-invasive types (A and B) (86.0%) and well-differentiated histology (93.0%).
- Negative lymphatic invasion (94.7%) and no lymph node metastasis or pleural involvement.
- Excellent 5-year survival rate of 97.3% compared to larger tumors (75.5%-78.1%).
Conclusions:
- Peripheral lung adenocarcinomas ≤10 mm predominantly show non-invasive histopathologic types A and B.
- These types are suitable for thoracoscopic wedge resection.
- Other types may necessitate standard surgical procedures.