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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 6/2019

01-06-2019 | Lung Cancer | Original Article

Outcomes and predictive factors for pathological node-positive in radiographically pure-solid, small-sized lung adenocarcinoma

Authors: Hiroyuki Kayata, Mitsuhiro Isaka, Yukihiro Terada, Kiyomichi Mizuno, Yoshiyuki Yasuura, Hideaki Kojima, Yasuhisa Ohde

Published in: General Thoracic and Cardiovascular Surgery | Issue 6/2019

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Abstract

Objectives

The indication of limited resection for radiographically pure-solid, small-sized lung adenocarcinoma is controversial. This study aimed to reveal the long-term outcome of standard surgical treatment and determine the predictive factors for pathological lymph node metastasis in optimal candidates undergoing limited surgical resection for pure-solid, small-sized lung adenocarcinoma.

Methods

The medical records of 107 consecutive patients were retrospectively reviewed at our hospital between December 2002 and December 2013. Inclusion criteria were histopathological diagnosis of lung adenocarcinoma, radiographically pure-solid tumor, ≤ 2 cm tumor size measured using thin-section computed tomography, clinical N0M0, patients who underwent lobectomy with systematic or lobe-specific lymph node dissection, and R0 resection. Overall and disease-free survival curves were calculated using the Kaplan–Meier method. Clinicopathological factors predicting pathological node-positive metastasis were identified by univariate and multivariate analysis.

Results

The 5-year overall and disease-free survival rates were 91.4% and 87.3%, respectively. Multivariate analysis demonstrated maximum standardized uptake value > 5 as the independent predictor of pathological node-positive metastasis (odds ratio 3.81; 95% confidence interval 1.25–12.3; p = 0.02). In all patients, the pathological node-positive rate was 16.7%; in patients who had a maximum standardized uptake value of ≤ 5, the rate was 7.9%.

Conclusion

The long-term outcome of standard surgical treatment was favorable. Maximum standardized uptake value was a significant predictor of pathological node-positive metastasis; however, diagnostic accuracy was not favorable. Therefore, the selection of optimal candidates is difficult, and limited surgical resection may not be applicable in pure-solid, small-sized lung adenocarcinoma.
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Metadata
Title
Outcomes and predictive factors for pathological node-positive in radiographically pure-solid, small-sized lung adenocarcinoma
Authors
Hiroyuki Kayata
Mitsuhiro Isaka
Yukihiro Terada
Kiyomichi Mizuno
Yoshiyuki Yasuura
Hideaki Kojima
Yasuhisa Ohde
Publication date
01-06-2019
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 6/2019
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-018-01059-2

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