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Ann Thorac Surg 2004;78:1011-1016
© 2004 The Society of Thoracic Surgeons

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Original article: general thoracic

A clinicopathological study of resected adenocarcinoma 2 cm or less in diameter

^a Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan
^b Department of Radiology, Tokyo Medical University, Tokyo, Japan
^c Department of Pathology, Tokyo Medical University, Tokyo, Japan

Accepted for publication March 15, 2004.

^* Address reprint requests to Dr Ikeda, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
ikeda{at}wd5.so-net.ne.jp

BACKGROUND: The biological behavior of small adenocarcinoma is different in each patient and these are especially enormous differences when evaluating solid tumors and nonsolid tumors.

METHODS: A total of 159 adenocarcinomas 2 cm or less in diameter were studied. Several clinicopathological factors were retrospectively analyzed.

RESULTS: The diameter of the primary tumors was less than 1 cm in 47 patients, 1–1.5 cm in 49 patients, and 1.5–2 cm in 63 patients, respectively. Almost all patients (147) were pathologic N0 and there were 12 node-positive patients (7.5%). Lymph-node involvement was observed in 1 patient with a tumor diameter measuring less than 1 cm and in 11 patients with a tumor diameter measuring 1–2 cm. According to Noguchi' s classification, 33 patients belonged to class A or B, 71 patients belonged to class C, and 55 patients belonged to class D, E, or F. The ratio of ground-glass opacity (GGO) area in the main tumor in high resolution computed tomography was classified into two groups with a threshold of 50%. There were 44 patients with a GGO ratio of equal to or greater than 50%, none of which indicated lymph-node metastasis or tumor recurrence during follow-up (5-year survival = 100%). On the contrary among 115 patients with a GGO ratio less than 50%, lymph-node involvement was indicated in 12 patients (10.4%) and the 5-year survival rate was 83.9%.

CONCLUSIONS: The biological malignancy of small adenocarcinomas might be accurately evaluated by the proportion of GGO area as well as the Noguchi classification.

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