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Outcome of Resected Lung Cancers with Subcentimeter Solid Component on Computed Tomography
Takeshi Kawaguchi1, Daiki Yoshikawa1, Tokiko Nakai2
1Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan.
The Thoracic and Cardiovascular Surgeon
|November 2, 2022
Summary
Subcentimeter lung cancer rarely recurs. The consolidation/tumor ratio predicts recurrence-free and overall survival, guiding surgical choices between less invasive wedge resections and anatomical resections.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Pulmonary medicine
Background:
- Optimal surgical management for subcentimeter lung cancers remains unclear despite increased detection opportunities.
- Retrospective analysis of clinical outcomes for these small lung cancers is crucial.
Purpose of the Study:
- To examine the clinical outcomes of patients with subcentimeter lung cancers.
- Identify predictors of recurrence-free survival (RFS) and overall survival (OS).
Main Methods:
- Analysis of 118 patients undergoing curative resection for subcentimeter lung cancer (2005-2013).
- Multivariate Cox proportional hazards models used to determine independent predictors of RFS and OS.
- Comparison of outcomes between anatomical resections (lobectomies, segmentectomies) and wedge resections.
Main Results:
- Recurrence occurred in 6 patients with consolidation-predominant tumors (consolidation/tumor [C/T] ratio >0.5) who underwent wedge resections.
- The C/T ratio was an independent predictor of RFS (p=0.008) and OS (p=0.011).
- All patients who relapsed had undergone wedge resections.
Conclusions:
- Subcentimeter lung cancer generally has a low recurrence rate.
- The C/T ratio is a significant prognostic factor for recurrence and survival.
- Surgical approach (wedge vs. anatomical resection) should be carefully considered based on the C/T ratio to balance invasiveness and oncologic outcomes.
