Surgical outcomes of lung cancer measuring less than 1 cm in diameter

Interact Cardiovasc Thorac Surg. 2012 Nov;15(5):854-8. doi: 10.1093/icvts/ivs337. Epub 2012 Aug 17.

Abstract

Objectives: The increased use of computed tomography has led to an increasing proportion of lung cancers that are identified when still less than 1 cm in diameter. However, there is no defined treatment strategy for such cases. The aim of this study was to investigate the surgical outcomes of small lung cancers.

Methods: A total of 143 patients were retrospectively evaluated, who had undergone a complete surgical resection for lung cancer less than 1 cm in diameter between January 1995 and December 2011.

Results: The 143 study subjects included 62 male and 81 female patients. The mean age was 64.0 years (43-82 years). The mean tumour size was 0.8 cm (0.3-1.0 cm). Seventy-seven patients (53.8%) underwent lobectomy. Thirty-two patients (22.4%) underwent segmentectomy and 34 patients (23.8%) underwent wedge resection. The 3-, 5- and 10-year survival rates were 95.7, 92.2 and 85.7%, respectively, after resection for sub-centimetre lung cancer. There were no significant differences between sub-lobar resection and lobectomy. However, two patients (1.4%) had recurrent cancer and seven (4.9%) had lymph node metastasis.

Conclusions: The selection of the surgical procedure is important and a long-term follow-up is mandatory, because lung cancer of only 1 cm or less can be associated with lymph node metastasis and distant metastatic recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Early Detection of Cancer
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / mortality
  • Predictive Value of Tests
  • Retrospective Studies
  • Survival Rate
  • Thoracic Surgery, Video-Assisted* / adverse effects
  • Thoracic Surgery, Video-Assisted* / mortality
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tumor Burden