Long-term outcomes of 50 cases of limited-resection trial for pulmonary ground-glass opacity nodules

J Thorac Oncol. 2012 Oct;7(10):1563-6. doi: 10.1097/JTO.0b013e3182641b5c.


Introduction: From 1998 to 2002, we performed a trial of prospective limited resection for pulmonary ground-glass opacity lesions 2 cm or smaller. This is the second report on the long-term outcome.

Methods: The enrollment criteria of the trial were as follows: pulmonary peripheral nodule less than 2 cm, diagnosis or suspected diagnosis of clinical T1N0M0 carcinoma with ground-glass opacity and lack of evident pleural indentations or vascular convergence on high-resolution computed tomography. Limited-resection (wedge or segment) specimens were intraoperatively examined by frozen section. If the nodule was confirmed as Noguchi type A or B with a resection margin of greater than 1 cm, the incision was sutured and the patient followed up. The median surveillance period was 10 years.

Results: In a total of 50 enrolled participants, there were two Noguchi type A, 23 type B and 15 type C adenocarcinomas; five atypical adenomatous hyperplasias, four fibroses, and one granuloma. Although there were no patients with recurrence within the first 5 years, in four patients who underwent limited-resection pulmonary adenocarcinoma developed more than 5 years after the initial resection, of either cut-end recurrence or metachronous primary disease.

Conclusions: Of 26 patients who underwent limited resection, adenocarcinoma developed in four after more than 5 years. These were possibly cut-end recurrences. We concluded that 5 years is not a sufficient period for follow-up, and that limited resection should still be done only in a trial setting, even for small ground-glass opacity lesions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Follow-Up Studies
  • Humans
  • Hyperplasia / diagnostic imaging
  • Hyperplasia / pathology
  • Hyperplasia / surgery*
  • Japan / epidemiology
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Pneumonectomy*
  • Postoperative Complications*
  • Prognosis
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Solitary Pulmonary Nodule / pathology
  • Solitary Pulmonary Nodule / surgery*
  • Time Factors
  • Tomography, X-Ray Computed