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Ten-year follow-up of lung cancer patients with resected adenocarcinoma in situ or minimally invasive adenocarcinoma: Wedge resection is curative

  • Di Li
    Affiliations
    Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China

    Institute of Thoracic Oncology, Fudan University, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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  • Chaoqiang Deng
    Affiliations
    Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China

    Institute of Thoracic Oncology, Fudan University, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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  • Shengping Wang
    Affiliations
    Institute of Thoracic Oncology, Fudan University, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

    Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
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  • Yuan Li
    Correspondence
    Yuan Li, MD, PhD, Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai 200032, China
    Affiliations
    Institute of Thoracic Oncology, Fudan University, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
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  • Yang Zhang
    Correspondence
    Yang Zhang, MD, Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai 200032, China
    Affiliations
    Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China

    Institute of Thoracic Oncology, Fudan University, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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  • Haiquan Chen
    Correspondence
    Address for reprints: Haiquan Chen, MD, PhD, Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Rd, Shanghai 200032, China.
    Affiliations
    Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China

    Institute of Thoracic Oncology, Fudan University, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
    Search for articles by this author

      Abstract

      Objective

      This study aimed to reveal the long-term outcomes of patients with lung cancer with adenocarcinoma in situ or minimally invasive adenocarcinoma after resection, in the context of the different surgical resection types.

      Methods

      Patients with lung adenocarcinoma who underwent resection between December 2007 and December 2012 were reviewed. Patients with pathological adenocarcinoma in situ or minimally invasive adenocarcinoma were enrolled. Postoperative survival and risk of developing second primary lung cancer were analyzed.

      Results

      After reevaluating the histological findings of 1696 patients with lung adenocarcinoma, we enrolled 53 with adenocarcinoma in situ and 72 with minimally invasive adenocarcinoma for analyses. Of all 125 patients with adenocarcinoma in situ/minimally invasive adenocarcinoma, 86 (68.8%) were female, 114 (91.2%) were nonsmokers, and most of them (78, 62.4%) underwent wedge resection. The median follow-up period after surgery was 111 months. The 10-year recurrence-free survivals of adenocarcinoma in situ and minimally invasive adenocarcinoma were all 100%, and the 10-year overall survivals of adenocarcinoma in situ and minimally invasive adenocarcinoma were 98.1% and 97.2%, respectively. There was no difference in 10-year recurrence-free survival between patients who underwent lobectomy and wedge resection. EGFR mutations were detected in 63.1% (41/65) of patients who underwent mutational analysis. The risks of developing second primary lung cancer for adenocarcinoma in situ and minimally invasive adenocarcinoma 10 years after resection were 8.4% and 4.3% (P = .298), respectively, and were not correlated with EGFR mutation status (P = .525).

      Conclusions

      Pathological adenocarcinoma in situ and minimally invasive adenocarcinoma have no recurrence during 10-year follow-up after resection, regardless of surgical procedure types. Surgery is curative for these patients, and wedge resection is the preferred surgical procedure for nodules in the proper location.

      Video Abstract

      (mp4, (3.77 MB)
      Figure thumbnail fx1

      Key Words

      Abbreviations and Acronyms:

      AIS (adenocarcinoma in situ), CI (confidence interval), CT (computed tomography), GGO (ground-glass opacity), IAC (invasive lung adenocarcinoma), MIA (minimally invasive adenocarcinoma), OS (overall survival), RFS (recurrence-free survival), SPLC (secondary primary lung cancer)
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