[Limited resection for small peripheral lung cancer using intraoperative pathologic examination]

From 1996 to 2002, we performed intentional limited resection for small peripheral lung cancer using intraoperative pathologic examination. Wedge resection was performed in patients who had small peripheral adenocarcinoma (< or = 20 mm), suspected of being Noguchi type A or B, and confirmed by intraoperative pathologic examination. Extended segmentectomy was performed in the rest of patients (tumor diameter < or = 20 mm), and not suspected of being Noguchi type A or B. Hilar and mediastinal lymph nodes sampling was performed in this group. If lymph node metastasis was detected by the intraoperative pathologic examination, the surgical procedures was converted into a lobectomy with lymph node dissection. Limited resection was performed in 27 patients, wedge resection in 8, and extended segmentectomy in 19. All patients received wedge resection are alive without sign of recurrence. In extended segmentectomy, 17 patients are alive with no evidence of disease, 1 patient died of non-pulmonary disease, and 1 patient is alive with recurrent disease. The overall survival rate at 5 years was 100% in wedge resection, 91% in extended segmentectomy, and 79% in standard lobectomy. We conclude that limited resection for small peripheral lung cancer using intraoperative pathologic examination may be safe and effective procedure.