Clinical outcome of subcentimeter non-small cell lung cancer after surgical resection: single institution experience of 105 patients.

Abstract

The detection of subcentimeter lung cancers has significantly improved with advances in computed tomography and the emergence of screening protocols. We reviewed the clinicopathological features and surgical outcomes of patients with subcentimeter non-small cell lung cancer (NSCLC) in our institution. A total of 105 patients who underwent lobectomy or sublobar resection for subcentimeter NSCLCs were retrospectively reviewed. Clinicopathological characteristics and survival were analyzed statistically using Student's t-test for continuous variables, Fisher's exact for categorical variables and Cox regression for multivariable analysis. A total of 105 patients (35 male, 70 female; mean age 61.4, range 38-77 years) were analyzed. Patients underwent lobectomy (n = 71), segmentectomy (n = 19), or wedge resection (n = 15). The overall 5-year survival was 91.3%. No significant differences were observed in overall and recurrence-free survival after segmentectomy or lobectomy; patients undergoing wedge resection had shorter survival compared to those who underwent lobectomy. Elevated preoperative serum CEA levels and positive nodal status correlated with poorer survival, and were identified as independent prognostic factors in multivariate analysis. Systematic nodal dissection is recommended for patients with subcentimeter NSCLC. Segmentectomy offers comparable oncologic results to lobectomy. Elevated preoperative serum CEA level implies shorter survival for patients with these tiny tumors.