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Jeffrey L. Port
Nasser K. Altorki
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J Thorac Cardiovasc Surg 2006;132:1382-1388
© 2006 The American Association for Thoracic Surgery

General Thoracic Surgery

Long-term survival and recurrence in patients with resected non–small cell lung cancer 1 cm or less in size

Paul C. Lee, MD, Robert J. Korst, MD, Jeffrey L. Port, MD, Yaniv Kerem, BA, Amanda L. Kansler, MPH, Nasser K. Altorki, MD*

Department of Cardiothoracic Surgery, Weill-Cornell Medical Center, New York, NY.

Read at the Eighty-sixth Annual Meeting of The American Association for Thoracic Surgery, Philadelphia, Pa, April 29-May 3, 2006.

Received for publication April 17, 2006; revisions received August 16, 2006; accepted for publication August 31, 2006.

* Address for reprints: Nasser K. Altorki, MD, Department of Cardiothoracic Surgery, Suite M404, New York Presbyterian Hospital—Weill Medical College of Cornell University, 525 East 68th St, New York, NY 10021 (Email: nkaltork{at}med.cornell.edu).

OBJECTIVE: With the widespread use of computed tomography and the emergence of screening programs, non–small cell lung cancer is increasingly detected in sizes 1 cm or less. We sought to examine the long-term survival and recurrence patterns after resection of these tumors.

METHODS: We conducted a retrospective review over a 15-year period to identify patients with surgically resected non–small cell lung cancer measuring 1 cm or less. Medical records were reviewed, and survival data were analyzed by the Kaplan-Meier method.

RESULTS: There were 83 patients (26 men, 57 women) with a median age of 67 years (range 43-88 years). Median tumor size was 0.90 cm. Lobectomy was performed in 71 patients, bilobectomy in 1, pneumonectomy in 1, segmentectomy in 5, and wedge resection in 5. Postoperative stage was IA in 67 patients, IB in 4, IIA in 1, IIB in 4, IIIA in 2, and IIIB in 5. Median follow-up was 31 months. There was 1 operative death (1.2%). In 5 (31.3%) of the 16 patients with non-IA disease, recurrent cancer developed after resection. No recurrences were observed in the 67 patients with stage IA disease. The 5- and 10-year overall survivals for the entire cohort were 86% and 72%, respectively, and the disease-specific survival was 91% at both time points. For patients with stage IA disease, 5- and 10-year survivals were 94% and 75%, respectively, and the disease-specific survival was 100% at both time points.

CONCLUSION: Eighty-one percent of patients with resected non–small cell lung cancer measuring 1 cm or less had stage IA disease. After surgical resection, recurrence is rare and long-term survival is excellent.

Abbreviations and Acronyms CI = confidence interval; CT = computed tomography; ELCAP = Early Lung Cancer Action Program; NSCLC = non–small cell lung cancer; PET = positron emission tomography


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Discussion
J. Thorac. Cardiovasc. Surg. 2006 132: 1388-1389. [Extract] [Full Text] [PDF]



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