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Vol.38 No.7 contents | Japanese/English |
- Original Article -
Clinicopathological Characteristics, Prognostic Factors and Indications for Limited Surgery in Minute Peripheral Lung Cancer Measuring 10 mm or Less in Diameter
Michihiko Tajiri1, Youichi Kameda2, Takamitsu Maehara3 and Kazumasa Noda4Present address1, Department of Surgery, Kanto Rosai Hospital, Kawasaki City, Japan, Department of Pathology2, Thoracic Surgery3, and Internal Medicine4, Kanagawa Cancer Center, Yokohama City, Japan
Thirty-nine patients with minute peripheral lung cancer measuring 10 mm or less in diameter were evaluated. We analyzed the clinicopathological factors of these cases in order to examine the characteristics and indications for performing limited surgery on small-sized lung cancer since the numbers of such patients has recently been increasing. The type of operations performed included a lobectomy with an R2 node dissection in 25 and a wedge resection without node dissection in 14 cases. The cases undergoing node dissection were pathologically diagnosed to be N1 in one and N0 in the other 24 cases. In addition, all cases were also classified as PM0. The tumors in all 39 cases consisted of 33 adenocarcinomas (25 well differentiated, 6 moderately differentiated, and 2 poorly differentiated), 5 carcinoids and 1 large cell carcinoma. Regarding the proliferative pattern in the adenocarcinomas, 25 were alveolar replacement type, and 8 were alveolar destructive type. Concerning fibrotic foci, 20 were non-fibrotic, 7 were elastic and 6 were collagenous type. Regarding the cell height, 3 were tall, 9 were medium height, and 21 were short. One patient with an adenocarcinoma had bone metastases but is alive. In addition, one patient with a carcinoid tumor had liver metastases and died due to recurrence, and one patient died due to heart disease, however all other 36 patients are still healthy and alive. The pathological findings of both the N1 case and the case with bone metastases were thus demonstrated to be either poorly or moderately differentiated adenocarcinoma with remarkable fibrosis and both were classified as alveolar destructive type. Generally patients presenting with tumors measuring 10 mm or less in diameter tend to have a good prognosis, but some cases with the above characteristics may also have pathologically advanced cancer, and thus are not suitable to undergo limited surgery using either a wedge resection or a segmental resection.
key words: Lung cancer, Small size, Limited surgery, Bronchioloalveolar cell carcinoma, Height of cell
Received: August 17, 1998
Accepted: September 29, 1998
JJLC 38 (7): 847-853, 1998
