Sagawa M, et al. - A prospective multi-institutional study evaluating the validity of limited resection for small-sized pulmonary adenocarcinoma with ground-glass opacity (GGO) was conducted. Researchers performed limited resection safely without any recurrence with the criteria of this study. Here, the postoperative pulmonary function was well preserved. For small-sized lung cancer with GGOs that met the criteria of this study, the outcomes of limited resection were satisfactory.

Methods

• For this study, the inclusion criteria were 25–80 years of age, no prior treatment, a maximum tumour diameter of 8–20 mm, a GGO ratio of ≥ 80%, clinical T1N0M0, lower 18F-fluorodeoxyglucose accumulation than the mediastinum, resectable by sublobar resection, pulmonary lobectomy tolerable and an intraoperative pathological diagnosis of bronchiloalveolar carcinoma.
• Researchers preferred wedge resection, but permitted segmentectomy.
• Disease-specific survival and overall survival were analyzed.

Results

• From 13 institutions, 73 patients were enrolled from November 2006 to April 2012.
• Researchers identified that 1 patient was ineligible, and the remaining 72 patients were preregistered.
• Intraoperatively, the tumours of 3 patients were diagnosed as benign lesions and 14 patients as adenocarcinomas with mixed subtype.
• In 2 patients, intraoperative cytological/histological examination of surgical margin was not performed, and ultimately, the remaining 53 patients were eligible for this study.
• They noticed the mean tumour size of 14.0 mm and the mean GGO ratio of 95.9%.
• Wedge resection and segmentectomy were performed on 39 and 14 patients, respectively.
• Despite intraoperative diagnosis of bronchioloalveolar carcinomas of all tumours, 6 were ultimately diagnosed as adenocarcinoma with a mixed subtype.
• They performed no completion lobectomy.
• As of 1 May 2017, they recognized no recurrence of the original lung cancer during 60.0–126.3 months after surgery.
• Death of 2 patients from other diseases was noticed.
• They noticed the 5-year disease-specific and overall survival rates of 100% and 98.1%, respectively.
• Minimal reduction in the pulmonary function was evident after limited resection.