2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07A.22 The Optimal Surgical Procedure Based on the Risk of Recurrence in Clinical Stage 0 or IA Lung Adenocarcinoma

EP.07A.22 The Optimal Surgical Procedure Based on the Risk of Recurrence in Clinical Stage 0 or IA Lung Adenocarcinoma

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This study investigates optimal surgical procedures for patients with clinical stage 0 or IA lung adenocarcinoma, focusing on minimizing the risk of recurrence. It considers sublobar resection versus lobectomy, examining how factors such as tumor size and characteristics influence outcomes. Previous randomized controlled trials like JCOG0802 and CALGB140503 have shown that sublobar resection can be as effective as lobectomy for survival, especially in tumors 2 cm or less in diameter. These studies used specific criteria, like the maximum tumor diameter and consolidation tumor ratio, differing from the current tumor node metastasis (TNM) staging system.<br /><br />In this research, 508 patients were analyzed concerning survival based on clinical T descriptors, CT features, and surgical procedures. Out of these, 180 underwent sublobar resection, while 328 had lobectomy. Outcomes varied depending on tumor presentation: pure ground-glass opacity (GGO) and cT1mi (minimally invasive) cases showed favorable outcomes with sublobar resection, while lobectomy was recommended for more solid tumors at the cT1b or cT1c stages to prevent recurrence.<br /><br />Ongoing and prior Phase III trials continue to evaluate these procedures' efficacy for different lung cancer scenarios. For example, the JCOG1211 trial supports segmentectomy for GGO or GGO-dominant tumors 3 cm or less in diameter. Current trials (WJOG16923L and JCOG2217) are assessing whether segmentectomy can be as effective as lobectomy for slightly larger tumors.<br /><br />The study conclusion suggests that surgical decisions should be personalized, taking into account the tumor’s specific characteristics to balance the benefits of more limited surgical approaches with the risk of recurrence. This research aims to refine treatment strategies to improve survival outcomes for lung adenocarcinoma patients.

Asset Subtitle

Tomoyoshi Takenaka

Meta Tag

Speaker Tomoyoshi Takenaka

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

lung adenocarcinoma

sublobar resection

lobectomy

tumor size

recurrence risk

JCOG0802

CALGB140503

ground-glass opacity

TNM staging

personalized surgery