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Predictive factors of recurrence after resection of subsolid clinical stage IA lung adenocarcinoma

 Dong Jin Im  ;  Sang Min Lee  ;  Kyunghwa Han  ;  Chul Hwan Park  ;  Ji Won Lee  ;  Sung Ho Hwang  ;  Jae Seung Seo  ;  Woocheol Kwon  ;  Kye Ho Lee  ;  Jin Hur 
 THORACIC CANCER, Vol.12(6) : 941-948, 2021-03 
Journal Title
Issue Date
lobectomy ; lung adenocarcinoma ; segmentectomy ; subsolid nodule ; wedge resection
Background: Ongoing studies are currently investigating the extent of surgical resection required for subsolid cancers. This study aimed to investigate the predictive factors related to recurrence in patients with clinical stage IA subsolid cancer who underwent either lobectomy or sublobar resection. Methods: This was a prospective multicenter observational study conducted in eight qualifying university teaching hospitals between April 2014 and December 2016. A total of 173 patients with subsolid nodules pathologically confirmed to have primary lung adenocarcinoma and stage IA disease were included in the final analysis. All patients underwent lobectomy, segmentectomy, or wedge resection performed by experienced thoracoscopic surgeons at each site. The surgical procedure was chosen based on the decision of the surgeons involved. The primary endpoint was time to recurrence (TTR). Results: The study population was 43.9% (76 of 173) male with a mean age of 60.7 years. During the median follow-up period of 5.01 years, nine patients (5%) experienced disease recurrence. In the multivariable analysis, tumor size (size ≥2 cm) (hazard ratio: 73.717, 95% confidence interval [CI]: 3.635-895.036; p < 0.001) and stage IA3 (hazard ratio: 62.010, 95% CI: 2.837-855.185; p < 0.001) were independent predictors of tumor recurrence. When analyzing the recurrence outcome in patients according to surgical procedure, no significant difference was found in TTR among the three groups (i.e., lobectomy, segmentectomy, and wedge resection; p = 0.99). Conclusions: Patients with radiologically subsolid lung adenocarcinoma measuring <3 cm could be candidates for sublobar resection instead of lobectomy.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
Lee, Kye Ho(이계호) ORCID logo https://orcid.org/0000-0001-5568-1833
Im, Dong Jin(임동진) ORCID logo https://orcid.org/0000-0001-8139-5646
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
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