초록접수 현황
| 17F-092 | 구연 발표 |
Long-term Outcomes of Radiographically Noninvasive Adenocarcinoma of the Lung According to the Surgical Strategy: Video-assisted Thoracoscopic Surgery (VATS) Lobectomy Versus VATS Sublobar Resection
Jae Kwang Yun, Min Kyun Kang, Geun Dong Lee, Byung Kwon Chong, Han Pil Lee, Se Hoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : The aim of this study is to evaluate the long-term outcomes of surgical resection for patients with cT1a radiographically noninvasive adenocarcinoma, which shows a consolidation-to-tumor ratio(C/T ratio) on chest CT 0.25 or less, according to the surgical strategy.
Methods : We evaluated a retrospective data of 133 patients(median, 58 years, range, 36-79 years; 64 males) who underwent VATS pulmonary resection for cT1a radiographically noninvasive adenocarcinoma from January 2008 to December 2015. If a C/T ratio of tumor was 0.25 or less on chest CT, the tumor was regarded as radiographically noninvasive adenocarcinoma. The type of surgery included lobectomy in 69(51.9%), and sublobar resection in 64 patients(48.1%). In sublobar resection group, 43 patients underwent wedge resection and 21 patients underwent segmentectomy.
Results : The mean follow-up period was 41.2 months. There was no in-hospital mortality or late dearth. 2 patients(1.5%) had recurrence in the lobectomy group, whereas there was no recurrence in the sublobar resection group. The freedom from recurrence rate at 5 years was 95.2±3.5% in the lobectomy group. There was no significant difference in recurrence rates(log rank, P=0.5. FEV1(%)was significantly decreased in patients undergoing lobectomy(92.1±13.9 to 81.5±16.7,P<0.001), but, it was not severely compromised by sublobar resection(89.0±13.0 to 86.3±14.8, P<0.001). In sublobar resection group, FEV1 was siginificantly decreased in patients undergoing segmentectomy(86.6±12.9 to 81.9±10.0, P=0.025), but not in patients undergoing wedge resection(90.2±13.0 to 88.4±16.4,P=0.233).
Conclusion : Sublobar resection shows the comparable clinical outcomes for patients with cT1a radiographically noninvasive adenocarcinoma which shows a C/T ratio 0.25 or less. Considering pulmonary function, wedge resection may be preferred.
Methods : We evaluated a retrospective data of 133 patients(median, 58 years, range, 36-79 years; 64 males) who underwent VATS pulmonary resection for cT1a radiographically noninvasive adenocarcinoma from January 2008 to December 2015. If a C/T ratio of tumor was 0.25 or less on chest CT, the tumor was regarded as radiographically noninvasive adenocarcinoma. The type of surgery included lobectomy in 69(51.9%), and sublobar resection in 64 patients(48.1%). In sublobar resection group, 43 patients underwent wedge resection and 21 patients underwent segmentectomy.
Results : The mean follow-up period was 41.2 months. There was no in-hospital mortality or late dearth. 2 patients(1.5%) had recurrence in the lobectomy group, whereas there was no recurrence in the sublobar resection group. The freedom from recurrence rate at 5 years was 95.2±3.5% in the lobectomy group. There was no significant difference in recurrence rates(log rank, P=0.5. FEV1(%)was significantly decreased in patients undergoing lobectomy(92.1±13.9 to 81.5±16.7,P<0.001), but, it was not severely compromised by sublobar resection(89.0±13.0 to 86.3±14.8, P<0.001). In sublobar resection group, FEV1 was siginificantly decreased in patients undergoing segmentectomy(86.6±12.9 to 81.9±10.0, P=0.025), but not in patients undergoing wedge resection(90.2±13.0 to 88.4±16.4,P=0.233).
Conclusion : Sublobar resection shows the comparable clinical outcomes for patients with cT1a radiographically noninvasive adenocarcinoma which shows a C/T ratio 0.25 or less. Considering pulmonary function, wedge resection may be preferred.
첨부파일 : Fig 1.docx
책임저자: Geun Dong Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Jae Kwang Yun, E-mail : janies@nate.com