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Limited resection and two-staged lobectomy for non-small cell lung cancer with ground-glass opacity

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Title: Limited resection and two-staged lobectomy for non-small cell lung cancer with ground-glass opacity
Authors: Ohtaka, Kazuto Browse this author
Hida, Yasuhiro Browse this author →KAKEN DB
Kaga, Kichizo Browse this author →KAKEN DB
Kato, Tatsuya Browse this author
Muto, Jun Browse this author
Nakada-Kubota, Reiko Browse this author
Hirano, Satoshi Browse this author →KAKEN DB
Matsui, Yoshiro Browse this author →KAKEN DB
Keywords: Ground-glass opacity
Two-staged surgery
Noguchi type
Lung cancer
Issue Date: 24-Apr-2013
Publisher: BioMed Central
Journal Title: Journal of Cardiothoracic Surgery
Volume: 8
Publisher DOI: 10.1186/1749-8090-8-111
PMID: 23618098
Abstract: Background: Lung tumors showing ground-glass opacities on high-resolution computed tomography indicate the presence of inflammation, atypical adenomatous hyperplasia, or localized bronchioloalveolar carcinoma. We adopted a two-staged video-assisted thoracoscopic lobectomy strategy involving completion lobectomy for localized bronchioloalveolar carcinoma with an invasive component according to postoperative pathological examination by permanent section after partial resection. Methods: Forty-one patients with undiagnosed small peripheral ground-glass opacity lesions underwent partial resection from 2001 to 2007 in Hokkaido University Hospital. Localized bronchioloalveolar carcinoma was classified according to the Noguchi classification for adenocarcinoma. Malignant lesions other than Noguchi types A and B were considered for completion lobectomy and systemic mediastinal lymphadenectomy. Perioperative data of completion video-assisted thoracoscopic lobectomies were compared with data of 67 upfront video-assisted thoracoscopic lobectomies for clinical stage IA adenocarcinoma performed during the same period. Results: Postoperative pathological examination revealed 35 malignant and 6 non-malignant diseases. Histologically, all of the malignant diseases were adenocarcinomas of Noguchi type A (n = 7), B (n = 9), C (n = 18), and F (n = 1). Eleven of 19 patients (58%) with Noguchi type C or F underwent two-staged video-assisted thoracoscopic lobectomy. Three patients refused a second surgery. There was no cancer recurrence. The two-staged lobectomy group had a significantly longer operative time and more blood loss than the upfront lobectomy group. There was no surgical mortality or cancer recurrence. Conclusions: Two-staged lobectomy for undiagnosed small peripheral ground-glass opacity lesions showed satisfactory oncological results. However, low compliance for and invasiveness of the second surgery are concerns associated with this strategy.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 樋田 泰浩

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