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Ann Thorac Surg 2002;73:1071-1075
© 2002 The Society of Thoracic Surgeons
a Departments of Thoracic and Vascular Surgery, Kurobe, Japan
b Department of Radiology, Kurobe, Japan
c Department of Pathology, Kurobe City Hospital, Kurobe, Japan
Accepted for publication December 11, 2001.
* Address reprint requests to Dr Shun-ichi Watanabe, Department of Thoracic and Vascular Surgery, Kurobe City Hospital, Kurobe 938-8502, Japan
e-mail: shunuk{at}aol.com
Background. Focal bronchioloalveolar carcinoma (BAC) showing pure ground-glass attenuation (GGA) on thin-section computed tomography (CT), which is considered to be an early-stage adenocarcinoma, has been diagnosed with increasing frequency due to the development and spread of the helical CT scanner. We discussed the appropriateness of limited resection for this type of lesion.
Methods. Between July 1996 and June 2001, 17 patients with localized BAC showing "pure GGA" (GGA without central scar formation) on thin-section CT underwent limited pulmonary resections. The mean patient age was 57.2 ± 10.5 years old. Among these patients, four tumors were detected in a CT mass-screening program and the others were incidentally detected on CT during follow-up for other diseases. Fourteen patients underwent thoracoscopic wedge resection, and 3 underwent segmentectomy because of tumor location.
Results. The mean tumor diameter was 7.9 ± 1.9 mm. On pathological examination, all tumors showed a pure bronchioloalveolar growth pattern and no evidence of stromal, vascular, or pleural invasion. The median follow-up time was 32.0 months, with no cancer death or relapse to date.
Conclusions. Focal BAC showing pure GGA on thin-section CT is peripheral in situ adenocarcinoma. Wedge resection by VATS is considered to be an appropriate treatment for this type of lung cancer. It can be a minimally invasive complete resection for this type of early cancer, and offer the best chance for long-term survival and good quality of life.
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