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World Journal of Surgery

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01-07-2018 | Original Scientific Report

Preoperative Watchful–Waiting Time and Surgical Outcome of Patients with Non-small Cell Lung Cancer Found by Chest Low-Dose CT Screening

Authors: Takaomi Hanaoka, Makoto Kurai, Mitsuyo Okada, Satoshi Ishizone, Fumitoshi Karasawa, Akira Iizuka

Published in: World Journal of Surgery | Issue 7/2018

Abstract

Backgrounds

Chest low-dose CT screening (LDCTS) has been finding unprecedented numbers of peripheral non-small cell lung cancers (NSCLC) at an early stage and increased the number of patients with surgical indication. It is important to explore the influence of preoperative watchful–waiting time (WWT) on surgical outcomes. Objective is to clarify relationship between WWT and surgical outcomes of LDCTS-finding NSCLC from the view point of treatment delay.

Methods

Total 283 cases of NSCLC, found by LDCTS and consecutively resected, were surveyed for preoperative WWT and surgical outcomes. Validity of the present guideline for management of pulmonary nodules detected by LDCTS was verified whether WWT before surgery was suitable for eradication of NSCLC.

Results

The median value of WWT was 4.0 months in total, and the distribution of WWT exhibited long-tail-type pattern. That was 5.0 months in the group of pure ground-glass nodule (pGGN), 4.0 months in the group of part-solid nodule (PSN), and 1.7 months in the group of solid nodule (SON). During long-term postoperative observation time (median 79 months), 10-year progression-free survival rates were 100% in pGGN, 96% in PSN, and 72% in SON (P < .0001). They decreased significantly depending on enlargement of size: 91% or higher in size of 2 cm or smaller, and 71% or lower in size of larger than 2 cm (P < .0001).

Conclusions

Limited to LDCTS-finding nodules, surgical outcome will depend mainly on some malignant potential of NSCLC per se, rather than on duration of WWT or treatment delay.

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Title: Preoperative Watchful–Waiting Time and Surgical Outcome of Patients with Non-small Cell Lung Cancer Found by Chest Low-Dose CT Screening
Authors: Takaomi Hanaoka
Makoto Kurai
Mitsuyo Okada
Satoshi Ishizone
Fumitoshi Karasawa
Akira Iizuka
Publication date: 01-07-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 7/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4439-z

At a glance: The STEP trials

Springer Medicine

Preoperative Watchful–Waiting Time and Surgical Outcome of Patients with Non-small Cell Lung Cancer Found by Chest Low-Dose CT Screening

Abstract

Backgrounds

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Backgrounds

Methods

Results

Conclusions

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