2010 Volume 24 Issue 7 Pages 1004-1010
Sublobar resection for small-sized lung cancer remains controversial. We herein propose a treatment algorithm for the limited resection of small-sized lung cancer on the basis of a retrospective analysis of the CT findings, tumor diameter, serum CEA level, and pleural invasion in 168 patients. The 5-year disease-free survival (5-Y-DFS) was 90.3%. Neither lymph node involvement nor recurrence was observed in 50 patients with ground glass opacity (GGO)-dominant lesions. One lymph node metastasis and two recurrences were found in 36 patients with solid-dominant lesions. Of 82 patients with solid lesions, 14 (17.1%) had lymph node metastases, which tended to be frequent in patients with high serum CEA levels. The 5-Y-DFS was 81.1%, and recurrence was significantly more frequent in patients with high serum CEA levels and pleural invasion. In conclusion, a lobectomy should be recommended for small-sized solid lesions larger than 1 cm, while a segmentectomy could be indicated for GGO lesions or solid-dominant lesions smaller than 1.5 cm. A sublobar resection for solid lesions smaller than 1 cm should be carefully considered.
