Korean Journal of Thoracic and Cardiovascular Surgery 2018; 51(6): 376-383  https://doi.org/10.5090/kjtcs.2018.51.6.376
Surgical Outcomes of Radiographically Noninvasive Lung Adenocarcinoma according to Surgical Strategy: Wedge Resection, Segmentectomy, and Lobectomy
Keong Jun Ha, M.D.1, Jae Kwang Yun, M.D.2, Geun Dong Lee, M.D.2, Won Chul Cho, M.D.1, Se Hoon Choi, M.D.2, Hyeong Ryul Kim, M.D.2, Yong Hee Kim, M.D.2, Dong Kwan Kim, M.D.2, and Seung-Il Park, M.D.2
1Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, 
2Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
Corresponding author: Geun Dong Lee, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
(Tel) 82-2-3010-3579 (Fax) 82-2-3010-6966 (E-mail) geundy@hanmail.net
Received: July 12, 2018; Revised: October 4, 2018; Accepted: October 16, 2018.; Published online: December 5, 2018.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

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Abstract
Background: The aim of this study was to evaluate the outcomes of surgical resection in patients with radiographically noninvasive lung adenocarcinoma according to the surgical strategy. Methods: A retrospective study was conducted of 128 patients who underwent pulmonary resection for ground-glass opacity (GGO)– dominant nodules measuring ≤2 cm with a consolidation/tumor ratio ≤0.25 based on computed tomography between 2008 and 2015. The 5-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were analyzed. Results: Among the 128 patients, wedge resection, segmentectomy, and lobectomy were performed in 40 (31.2%), 22 (17.2%), and 66 patients (51.6%), respectively. No significant differences were found among the groups in the mean size of tumors (p=0.119), the rate of pure-GGO nodules (p=0.814), the consolidation/tumor ratio (p=0.695), or the rate of invasive adenocarcinoma (p=0.378). Centrally located tumors were more common in the lobectomy group (21.2%) than in the wedge resection (0%) or segmentectomy (0%) groups (p=0.001). There were no significant differences in the 5-year DFS rate (100%, 100%, 92.7%, respectively; p=0.76) or 5-year OS rate (100%, 100%, 100%; p=0.223) among the wedge resection, segmentectomy, and lobectomy groups. Conclusion: For radiographically noninvasive lung adenocarcinoma measuring ≤2 cm with a consolidation/tumor ratio ≤0.25, wedge resection and segmentectomy could be comparable surgical options to lobectomy.
Keywords: Adenocarcinoma, Nodules, solitary pulmonary, Lobectomy, Chest, Computed tomography


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