Clinicopathologic Features of Resected Subcentimeter Lung Cancer

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Clinicopathologic Features of Resected Subcentimeter Lung Cancer Hiroyuki Sakurai, MD, Kazuo Nakagawa, MD, Shun-ichi Watanabe, MD, Hisao Asamura, MD The Annals of Thoracic Surgery Volume 99, Issue 5, Pages 1731-1738 (May 2015) DOI: 10.1016/j.athoracsur.2015.01.034 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 High-resolution computed tomographic appearance according to type of lesion. (A) Type 1: nonsolid ground-glass opacity (GGO) lesion. (B) Type 2: part-solid GGO lesion with a consolidation to tumor ratio of 0.5 or less, indicating a tumor with a wide GGO area. (C) Type 3: part-solid GGO lesion with a consolidation to tumor ratio of more than 0.5. (D) Type 4: solid lesion with no GGO area. The Annals of Thoracic Surgery 2015 99, 1731-1738DOI: (10.1016/j.athoracsur.2015.01.034) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Three cases of local relapse along a previous surgical margin. (A) Patient 1: a recurrent tumor (lower row) developed adjacent to a surgical staple line (black arrow) 41 months after wedge resection for type 3 tumor (upper row). (B) Patient 2: a recurrent tumor (lower row) developed adjacent to a surgical staple line (black arrow) 20 months after segmentectomy for type 4 tumor (upper row). (C) Patient 3: a recurrent tumor (lower row) developed adjacent to a surgical staple line (black arrow) 78 months after wedge resection for type 4 tumor (upper row). The Annals of Thoracic Surgery 2015 99, 1731-1738DOI: (10.1016/j.athoracsur.2015.01.034) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Disease-free survival and (B) overall survival curves for all 291 patients with peripheral subcentimeter lung cancer. The 5-year disease-free and overall survival rates are 95.8% and 95.0%, respectively. The Annals of Thoracic Surgery 2015 99, 1731-1738DOI: (10.1016/j.athoracsur.2015.01.034) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Disease-free survival and (B) overall survival curves based on type of lesion. The 5-year disease-free survival rates are 100% in type 1 and type 2, 98% in type 3, and 88% in type 4, respectively. The 5-year overall survival rates are 100% in type 1, 98% in type 2, 98% in type 3, and 88% in type 4, respectively. Type 4 has a significantly worse prognosis than the other types with regard to both overall (p = 0.001) and disease-free (p = 0.000) survival. The Annals of Thoracic Surgery 2015 99, 1731-1738DOI: (10.1016/j.athoracsur.2015.01.034) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Algorithm of surgical management for subcentimeter lung cancer based on each type. (CT = computed tomography; GGO = ground-glass opacity.) The Annals of Thoracic Surgery 2015 99, 1731-1738DOI: (10.1016/j.athoracsur.2015.01.034) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Trend in percentage of subcentimeter tumors in resected lung cancer from 1993 to 2011. With the passage of years, the incidence of subcentimeter lung cancer increased more and more. The Annals of Thoracic Surgery 2015 99, 1731-1738DOI: (10.1016/j.athoracsur.2015.01.034) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions