Sublobar Resection Margin Width Does Not Affect Recurrence of Clinical N0 Non-small Cell Lung Cancer Presenting as GGO-Predominant Nodule of 3cm or Less.

Abstract

Sublobar resection of lung cancer may benefit patients with lung cancer presenting as ground-glass opacity (GGO) nodules. The purpose of this study was to evaluate the effect of margin width on recurrence after sublobar resection in patients with clinical N0 non-small cell lung cancer presenting as GGO-predominant nodule. We conducted a retrospective chart review of 91 patients treated for clinical N0 non-small cell lung cancer ≤3 cm by sublobar resection with clear resection margins. We assigned them to two groups: GGO-predominant tumor and solid-predominant tumor. Each group was subdivided into two groups according to the margin width: resection margin ≤5mm and resection margin >5mm. We analyzed the clinicopathological findings and survival among these four groups. There was no recurrence in GGO-predominant tumors after sublobar resection. Margin width did not influence the recurrence in GGO-predominant tumors. In the cases of solid-predominant tumor, 5-year recurrence-free survival after sublobar resection according to margin width ≤5 and >5mm was 24.2 and 79.6%, respectively (p<0.001). Therefore, narrow margin width (resection margin ≤5mm) was a significant risk factor for recurrence of solid-predominant tumors (hazard ratio 3.868, 95% confidence interval 1.177-12.714, p=0.026). The width between the tumor and resection margin does not affect the recurrence after R0 sublobar resection in patients with clinical N0 GGO-predominant lung cancer ≤3cm. By contrast, margin width is a significant risk factor for recurrence after sublobar resection in patients with clinical N0 solid-predominant lung cancer.