Pattern of metastasis outside tumor-bearing segments in primary lung cancer: Rationale for segmentectomy

Yuichi Sakairi, Ichiro Yoshino, Shigetoshi Yoshida, Hidemi Suzuki, Tetsuzo Tagawa, Takekazu Iwata, Teruaki Mizobuchi

Research output: Contribution to journalArticle

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Abstract

Background Patterns of intrapulmonary metastasis, particularly metastasis outside tumor-bearing segments, were investigated in lung cancer patients to address the rationale for segmentectomy. Methods In a consecutive series of patients who underwent resection of two or more pulmonary segments for primary lung cancer, intrapulmonary spread patterns, such as segmental/intersegmental node metastasis and pulmonary parenchymal metastasis, were pathologically examined. Results Eligible 244 lesions included 167 adenocarcinomas, 66 squamous cell carcinomas, and 11 large cell carcinomas. Pathologic stages included 0 to IA (n = 111), IB (n = 56), IIA (n = 31), IIB (n = 20), IIIA (n = 23), and IIIB to IV (n = 3); and N1 (n = 26) and N2 (n = 22). Intrapulmonary spread was observed in 24 cases (9.8%). Of these, metastasis outside tumor-bearing segments was only observed in 4 cases (1.6%), and such cancer spread was more frequently seen in cases with extrapulmonary (hilar to mediastinal) nodal metastasis (7.9%) than in cases without extrapulmonary metastasis (0.5%; p = 0.01). Metastasis outside tumor-bearing segments was not observed in 64 tumors with pure or mixed ground glass opacity features on computed tomography. Although tumor location (peripheral or central/intermediate) was not related to the incidence of metastasis outside tumor-bearing segments, intrapulmonary spread was observed in only 1 of 52 peripheral small (≤20 mm) tumors. Conclusions Metastasis outside tumor-bearing segments is rarely observed in cases with tumors (1) without extrapulmonary nodal metastasis and (2) with ground glass opacity or peripheral small (≤20 mm) features.

Original languageEnglish
Pages (from-to)1694-1700
Number of pages7
JournalAnnals of Thoracic Surgery
Volume97
Issue number5
DOIs
Publication statusPublished - Jan 1 2014
Externally publishedYes

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Segmental Mastectomy
Lung Neoplasms
Neoplasm Metastasis
Neoplasms
Glass
Large Cell Carcinoma
Lung
Squamous Cell Carcinoma
Adenocarcinoma
Tomography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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Pattern of metastasis outside tumor-bearing segments in primary lung cancer : Rationale for segmentectomy. / Sakairi, Yuichi; Yoshino, Ichiro; Yoshida, Shigetoshi; Suzuki, Hidemi; Tagawa, Tetsuzo; Iwata, Takekazu; Mizobuchi, Teruaki.

In: Annals of Thoracic Surgery, Vol. 97, No. 5, 01.01.2014, p. 1694-1700.

Research output: Contribution to journalArticle

Sakairi, Yuichi ; Yoshino, Ichiro ; Yoshida, Shigetoshi ; Suzuki, Hidemi ; Tagawa, Tetsuzo ; Iwata, Takekazu ; Mizobuchi, Teruaki. / Pattern of metastasis outside tumor-bearing segments in primary lung cancer : Rationale for segmentectomy. In: Annals of Thoracic Surgery. 2014 ; Vol. 97, No. 5. pp. 1694-1700.
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abstract = "Background Patterns of intrapulmonary metastasis, particularly metastasis outside tumor-bearing segments, were investigated in lung cancer patients to address the rationale for segmentectomy. Methods In a consecutive series of patients who underwent resection of two or more pulmonary segments for primary lung cancer, intrapulmonary spread patterns, such as segmental/intersegmental node metastasis and pulmonary parenchymal metastasis, were pathologically examined. Results Eligible 244 lesions included 167 adenocarcinomas, 66 squamous cell carcinomas, and 11 large cell carcinomas. Pathologic stages included 0 to IA (n = 111), IB (n = 56), IIA (n = 31), IIB (n = 20), IIIA (n = 23), and IIIB to IV (n = 3); and N1 (n = 26) and N2 (n = 22). Intrapulmonary spread was observed in 24 cases (9.8{\%}). Of these, metastasis outside tumor-bearing segments was only observed in 4 cases (1.6{\%}), and such cancer spread was more frequently seen in cases with extrapulmonary (hilar to mediastinal) nodal metastasis (7.9{\%}) than in cases without extrapulmonary metastasis (0.5{\%}; p = 0.01). Metastasis outside tumor-bearing segments was not observed in 64 tumors with pure or mixed ground glass opacity features on computed tomography. Although tumor location (peripheral or central/intermediate) was not related to the incidence of metastasis outside tumor-bearing segments, intrapulmonary spread was observed in only 1 of 52 peripheral small (≤20 mm) tumors. Conclusions Metastasis outside tumor-bearing segments is rarely observed in cases with tumors (1) without extrapulmonary nodal metastasis and (2) with ground glass opacity or peripheral small (≤20 mm) features.",
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AU - Suzuki, Hidemi

AU - Tagawa, Tetsuzo

AU - Iwata, Takekazu

AU - Mizobuchi, Teruaki

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N2 - Background Patterns of intrapulmonary metastasis, particularly metastasis outside tumor-bearing segments, were investigated in lung cancer patients to address the rationale for segmentectomy. Methods In a consecutive series of patients who underwent resection of two or more pulmonary segments for primary lung cancer, intrapulmonary spread patterns, such as segmental/intersegmental node metastasis and pulmonary parenchymal metastasis, were pathologically examined. Results Eligible 244 lesions included 167 adenocarcinomas, 66 squamous cell carcinomas, and 11 large cell carcinomas. Pathologic stages included 0 to IA (n = 111), IB (n = 56), IIA (n = 31), IIB (n = 20), IIIA (n = 23), and IIIB to IV (n = 3); and N1 (n = 26) and N2 (n = 22). Intrapulmonary spread was observed in 24 cases (9.8%). Of these, metastasis outside tumor-bearing segments was only observed in 4 cases (1.6%), and such cancer spread was more frequently seen in cases with extrapulmonary (hilar to mediastinal) nodal metastasis (7.9%) than in cases without extrapulmonary metastasis (0.5%; p = 0.01). Metastasis outside tumor-bearing segments was not observed in 64 tumors with pure or mixed ground glass opacity features on computed tomography. Although tumor location (peripheral or central/intermediate) was not related to the incidence of metastasis outside tumor-bearing segments, intrapulmonary spread was observed in only 1 of 52 peripheral small (≤20 mm) tumors. Conclusions Metastasis outside tumor-bearing segments is rarely observed in cases with tumors (1) without extrapulmonary nodal metastasis and (2) with ground glass opacity or peripheral small (≤20 mm) features.

AB - Background Patterns of intrapulmonary metastasis, particularly metastasis outside tumor-bearing segments, were investigated in lung cancer patients to address the rationale for segmentectomy. Methods In a consecutive series of patients who underwent resection of two or more pulmonary segments for primary lung cancer, intrapulmonary spread patterns, such as segmental/intersegmental node metastasis and pulmonary parenchymal metastasis, were pathologically examined. Results Eligible 244 lesions included 167 adenocarcinomas, 66 squamous cell carcinomas, and 11 large cell carcinomas. Pathologic stages included 0 to IA (n = 111), IB (n = 56), IIA (n = 31), IIB (n = 20), IIIA (n = 23), and IIIB to IV (n = 3); and N1 (n = 26) and N2 (n = 22). Intrapulmonary spread was observed in 24 cases (9.8%). Of these, metastasis outside tumor-bearing segments was only observed in 4 cases (1.6%), and such cancer spread was more frequently seen in cases with extrapulmonary (hilar to mediastinal) nodal metastasis (7.9%) than in cases without extrapulmonary metastasis (0.5%; p = 0.01). Metastasis outside tumor-bearing segments was not observed in 64 tumors with pure or mixed ground glass opacity features on computed tomography. Although tumor location (peripheral or central/intermediate) was not related to the incidence of metastasis outside tumor-bearing segments, intrapulmonary spread was observed in only 1 of 52 peripheral small (≤20 mm) tumors. Conclusions Metastasis outside tumor-bearing segments is rarely observed in cases with tumors (1) without extrapulmonary nodal metastasis and (2) with ground glass opacity or peripheral small (≤20 mm) features.

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