Margin Width of Resected Lepidic Lung Cancer Does Not Affect Recurrence After Sublobar Resection

Area of Science:

• Oncology
• Thoracic Surgery
• Pathology

Background:

• Sublobar resection for lung cancer necessitates adequate resection margins.
• Lepidic adenocarcinoma, being non- or minimally invasive, may not require specific margin widths.
• This study investigates the impact of resection margin width on outcomes for lepidic-dominant lung adenocarcinoma post-sublobar resection.

Purpose of the Study:

• To evaluate the relationship between resection margin width and patient outcomes in lepidic-dominant lung adenocarcinoma following sublobar resection.
• To compare outcomes between lepidic and non-lepidic tumors based on margin-to-tumor ratio.

Main Methods:

• A cohort of 133 patients with small (≤2 cm), clinical N0M0 lung cancer undergoing sublobar resection were analyzed.
• Patients were stratified into four groups based on tumor type (lepidic vs. non-lepidic) and margin-to-tumor ratio (<1 vs. ≥1).
• Clinicopathological features and survival outcomes were compared between groups.

Main Results:

• Patients with lepidic tumors achieved 100% 5-year recurrence-free survival (RFS) regardless of margin width (Groups A & B).
• For non-lepidic tumors, 5-year RFS was 49.9% for narrow margins and 97.1% for wider margins (Groups C & D, p=0.009).
• Multivariate analysis identified margin-to-tumor ratio as a significant independent factor for recurrence in non-lepidic tumors (HR=0.157, p=0.037).

Conclusions:

• Resection margin width is not associated with tumor recurrence in lepidic lung tumors after sublobar resection.
• A narrow resection margin is a significant risk factor for recurrence in non-lepidic lung tumors treated with sublobar resection.