Long-term outcomes after sublobar resection for clinical stage IA lung adenocarcinoma meeting node-negative criteria defined by HRCT and FDG-PET/CT.

Abstract

8554 Background: The purpose of this study is to evaluate long-term outcomes after sublobar resection for patients with clinical stage IA lung adenocarcinoma meeting our proposed node-negative (N0) criteria: solid component size of less than 0.8 cm on HRCT or SUVmax of less than 1.5 on FDG-PET/CT. Methods: Between April 2006 and December 2010, 347 patients with clinical stage IA lung adenocarcinoma underwent complete resection after preoperative HRCT and FDG-PET/CT in Kanagawa Cancer Center and Hiroshima University. Long-term outcomes of patients who met the N0 criteria after sublobar resection were evaluated. Results: Two-hundred one (57.9%) patients met the N0 criteria. Patients who met the N0 criteria were significantly associated with low grade adenocarcinoma subtype (adenocarcinoma in situ, minimally invasive adenocarcinoma, or lepidic adenocarcinoma; P < 0.001), negative lymphatic invasion (P < 0.001), negative vascular invasion (P < 0.001), and negative pleural invasion (P < 0.001). One of 201 (0.5%) patients had lymph node metastasis. The median follow-up period was 86.1 months. There was significant difference in overall survival (OS) between patients who met the N0 criteria (5-year OS rate, 93.9%; 10-year OS rate, 90.3%) and those who did not meet the N0 criteria (5-year OS rate, 81.5%; 10-year OS rate, 64.3%; P < 0.001). In patients who met the N0 criteria, there was no significant difference in OS between patients who underwent lobectomy (5-year OS rate, 94.3%; 10-year OS rate, 92.6%) and those who underwent sublobar resection (5-year OS rate, 93.8%; 10-year OS rate, 89.3%; P = 0.640). Conclusions: Sublobar resection is feasible for clinical stage IA lung adenocarcinoma meeting N0 criteria defined by HRCT and FDG-PET/CT with excellent long-term survival.