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Feasibility of limited resection for peripheral small-sized non-small cell lung cancer: a retrospective single-center-based study

  • Original Article – Clinical Oncology
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Abstract

Purpose

This study aimed to establish new criteria for limited resection of non-small cell lung cancer (NSCLC) based on computed tomography findings and maximum standardized uptake value (SUVmax).

Methods

Between December 2007 and December 2015, 611 patients underwent lung cancer surgery; of these, 70 with cT1aN0M0 who underwent limited resection were enrolled. Criteria for undergoing intentional limited resection (ILR) were (1) tumor ground-glass opacity (GGO) ratio of ≥ 0.75 and (2) tumor SUVmax ≤ 1.5. Patients who met criteria (1) and (2) underwent partial resection, and those who only met criteria (2) underwent segmentectomy as ILR. The control group was subjected to limited surgery without meeting the criteria.

Results

Overall, 45 and 25 patients who met the criteria were included in the ILR and control groups, respectively. In the ILR group, 13 patients underwent partial resection, and 32 underwent segmentectomy; in the control group, 18 patients underwent partial resection and 7 underwent segmentectomy. According to our criteria, no relapsed cases occurred in the ILR group, although six patients showed recurrence of lung cancer in the control group. The 5-year overall survival (OS) rates in the ILR and control groups were 100% and 67.7%, respectively, and the relapse-free survival (RFS) rates were 100% and 61.6%, respectively. The log-rank test showed that this difference was statistically significant (OS: P < 0.0001, RFS: P < 0.0001).

Conclusions

SUVmax may serve as a predictive marker of recurrence to determine the treatment strategy for patients with NSCLC. Patients with low GGO ratio and low SUVmax may be cured by limited resection.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

Authors

Contributions

YH and KK contributed to the conception of the study. MA, YH, and KK contributed to the study design. MA conducted the research. MA, TK, and AF analyzed the data, and MA wrote the manuscript. The final manuscript was read and approved by all authors.

Corresponding author

Correspondence to Masato Aragaki.

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Conflict of interest

All the authors report no conflicts of interest. The authors are responsible for the content and writing of the paper.

Ethical approval

The study was conducted in consent to the Declaration of Helsinki and was approved by the medical ethics committee of the Hokkaido University School of Medicine (Approval Number: #019-0349).

Informed consent

Informed consent was obtained from all patients, and all clinical investigations were conducted according to the ethical and legal standards. All authors have read and approved the manuscript for publication.

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Aragaki, M., Hida, Y., Kato, T. et al. Feasibility of limited resection for peripheral small-sized non-small cell lung cancer: a retrospective single-center-based study. J Cancer Res Clin Oncol 147, 1519–1527 (2021). https://doi.org/10.1007/s00432-020-03441-1

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  • DOI: https://doi.org/10.1007/s00432-020-03441-1

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