4.6 Article Proceedings Paper

A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer

期刊

出版社

MOSBY-ELSEVIER
DOI: 10.1016/j.jtcvs.2020.09.146

关键词

GGO; lung cancer; prognosis; sublobar resection

资金

  1. National Cancer Center Research and Development Fund
  2. Ministry of Health, Labour and Welfare of Japan
  3. AMED [JP15ck0106051h0002]

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This study evaluated the efficacy and safety of sublobar resection for ground-glass opacity dominant peripheral lung cancer. The results showed that sublobar resection provided sufficient local control and relapse-free survival for eligible patients.
Background: The optimal mode of surgery for ground-glass opacity dominant peripheral lung cancer defined with thoracic thin-section computed tomography remains unknown. Methods: We conducted a single-arm confirmatory trial to evaluate the efficacy and safety of sublobar resection for ground-glass opacity dominant peripheral lung cancer. Lung cancer with maximum tumor diameter 2.0 cm or less and with consolidation tumor ratio 0.25 or less based on thin-section computed tomography were registered. The primary end point was 5-year relapse-free survival. The planned sample size was 33o with the expected 5-year relapse-free survival of 98%, threshold of 95%, 1-sided alpha of 5%, and power of 90%. The trial is registered with University Hospital Medical Information Network Clinical Trials Registry, number University Hospital Medical Information Network 000002008. Results: Between May 2009 and April 2011, 333 patients were enrolled from 51 institutions. Median age was 62 years (interquartile range, 56-68), and 109 were smokers. Median maximum tumor diameter was 1.20 cm (1.00-1.54). Median maximum tumor diameter of consolidation was o (0.00-0.20). The primary end point, 5-year relapse-free survival, was estimated on 314 patients who underwent sublobar resection. Operative modes were 258 wide wedge resections and 56 segmentectomies. Median pathological surgical margin was 15 mm (0-55). The 5-year relapse-free survival was 99.7% (90% confidence interval, 98.3-99.9), which met the primary end point. There was no local relapse. Grade 3 or higher postoperative complications based on Common Terminology Criteria for Adverse Effect v3.0 were observed in 17 patients (5.4%), without any grade 4 or 5. Conclusions: Sublobar resection with enough surgical margin offered sufficient local control and relapse-free survival for lung cancer clinically resectable No staged by computed tomography with 3 or fewer peripheral lesions 2.0 cm or less amenable to sublobar resection and with a consolidation tumor ratio of 0.25 or less.

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