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[Analysis of patients with resected small-size (less than or equal to 2 cm in diameter) peripheral type lung cancer
M Sagawa1, Y Saitoh, S Takahashi
1Department of Surgery, Tohoku University, Sendai, Japan.
Abstract:
From 1953 to 1985, a total of 1289 patients with primary carcinoma of the lung underwent surgical treatment. Of these 116 (8.9%) had small-sized (less than or equal to 2 cm in diameter) peripheral type lung cancer lesions. This study had three purposes: 1) to analyse how small-sized lung cancer lesions were detected; 2) to evaluate the reliability of diagnosis of small-sized cancer lesions; and 3) to evaluate pre- and post-prognostic factors of such patients compared with patients with peripheral type lung cancer lesions 2.1-3 cm in diameter. Of the 115 patients with small-sized lung cancer lesions were detected in the course of mass surveys. Cytopathological diagnosis in 75% of the patients resulted from transbronchial brushing cytology. The 5-year survival rate of patients who underwent resection of small-sized peripheral type lung cancer lesions was 70% (2.1-3 cm; 52%). Various factors such as histologic type, nodal involvement, pleural involvement, pathological stage, and success of the operation were shown to significantly affect survival. A comparison of two groups, i.e., those with lesions smaller than 2 cm in diameter and those with lesions 2.1-3 cm in diameter, showed the rate of lymph node metastasis to be significantly different. Of the patients with peripheral lung cancer lesions smaller than 2 cm who underwent surgery, 21% had peribronchial, hilar, or mediastinal lymph node metastasis. On the other hand, lymph node metastasis was seen in 43% of cases with peripheral lung cancer lesions 2.1-3 cm in diameter who underwent surgery.
Insights
Early detection of small lung cancers (≤2 cm) via mass surveys improves survival rates significantly. These smaller peripheral lung cancers have a lower lymph node metastasis rate compared to larger lesions (2.1-3 cm).
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Oncology
Context:
- Analysis of 1289 patients with primary lung carcinoma treated surgically between 1953 and 1985.
- Focus on a subgroup of 116 patients (8.9%) with small-sized (≤2 cm diameter) peripheral lung cancer.
- Comparison group: patients with peripheral lung cancer lesions measuring 2.1-3 cm in diameter.
Purpose:
- To investigate detection methods for small-sized lung cancer lesions.
- To assess the diagnostic accuracy for small lung cancer lesions.
- To compare prognostic factors between small (≤2 cm) and larger (2.1-3 cm) peripheral lung cancers.
Summary:
- Small peripheral lung cancers (≤2 cm) were often detected through mass surveys, with transbronchial brushing cytology being a key diagnostic tool (75% of cases).
- The 5-year survival rate for resected small lung cancers (≤2 cm) was 70%, significantly higher than for larger lesions (2.1-3 cm; 52%).
- Lymph node metastasis was notably lower in small lung cancers (21%) compared to larger ones (43%).
Impact:
- Highlights the effectiveness of early detection strategies, such as mass surveys, in improving outcomes for lung cancer patients.
- Demonstrates that smaller tumor size is associated with a reduced risk of lymph node metastasis and better survival.
- Provides evidence supporting the importance of prompt surgical intervention for small peripheral lung cancers.