A prospective 5-year follow-up study after limited resection for lung cancer with ground-glass opacity

Motoyasu Sagawa, Hiroyuki Oizumi, Hiroyuki Suzuki, Hidetaka Uramoto, Katsuo Usuda, Akira Sakurada, Masayuki Chida, Satoshi Shiono, Jiro Abe, Tohru Hasumi, Masami Sato, Nobuyuki Sato, Jotaro Shibuya, Hiroyuki Deguchi, Yoshinori Okada

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39 Citations (Scopus)


OBJECTIVES: The incidence of small-sized pulmonary adenocarcinomas with ground-glass opacity (GGO) has recently increased, with excellent postoperative prognosis. The limited resection of such cancers has been deemed to be acceptable based on retrospective studies. We conducted a prospective multi-institutional study evaluating the validity of limited resection for small-sized pulmonary adenocarcinoma with GGO. METHODS: The inclusion criteria were 25-80 years of age, no prior treatment, a maximum tumour diameter of 8-20 mm, a GGO ratio of ≥ 80%, clinical T1N0M0, lower 18F-fluorodeoxyglucose accumulation than the mediastinum, resectable by sublobar resection, pulmonary lobectomy tolerable and an intraoperative pathological diagnosis of bronchiloalveolar carcinoma. Wedge resection was preferred, but segmentectomy was permitted. Disease-specific survival and overall survival were analysed. RESULTS: From November 2006 to April 2012, 73 patients were enrolled from 13 institutions. One patient was ineligible, and the remaining 72 patients were preregistered. The tumours of 3 and 14 patients were intraoperatively diagnosed as benign lesions and adenocarcinomas with mixed subtype, respectively. Intraoperative cytological/histological examination of surgical margin was not performed in 2 patients, and the remaining 53 patients were ultimately eligible for this study. The mean tumour size was 14.0mm and the mean GGO ratio was 95.9%. Thirty-nine and 14 patients underwent wedge resection and segmentectomy, respectively. Although all tumours were intraoperatively diagnosed as bronchioloalveolar carcinomas, 6 were ultimately diagnosed as adenocarcinoma with a mixed subtype. No completion lobectomy was performed. As of 1 May 2017, no recurrence of the original lung cancer was observed during 60.0-126.3 months after surgery. Two patients died from other diseases. The 5-year disease-specific and overall survival rates were 100% and 98.1%, respectively. The reduction in the pulmonary function after limited resection was minimal.

Original languageEnglish
Pages (from-to)849-856
Number of pages8
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number4
Publication statusPublished - 2018 Apr 1


  • Adenocarcinoma
  • Ground-glass opacity
  • Limited resection
  • Lung cancer
  • Prospective study


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