Long-term Outcome of Patients with Peripheral Ground Glass Opacity Dominant Lung Cancer After Sublobar Resections: Final Report of JCOG0804/WJOG4507L

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Abstract Submission 

Makoto Suzuki (1), Ichiro Yoshino (2), Yasumitsu Moriya (3), Kenji Suzuki (4), Masashi Wakabayashi (5), Hisashi Saji (6), keiju aokage (7), Hiroyuki Ito (8), Isao Matsumoto (9), Masashi Kobayashi (10), Tatsuro Okamoto (11), Morihito Okada (12), Motohiro Yamashita (13), Norihiko Ikeda (14), Shinichiro Nakamura (15), Tomoko Kataoka (16), Masahiro Tsuboi (17), Shun-ichi Watanabe (18)

(1) Kumamoto University Hospital, Kumamoto, Kumamoto, (2) Chiba University Hospital, Chiba, Chiba, (3) Chiba Rosai Hospital, Chiba, Ichihara, (4) Juntendo Hospital, Bunkyoku, Tokyo, (5) National Cancer Center East, Kashiwa, Chiba, (6) St. Marianna University School of Medicine, Kawasaki, Kanagawa, (7) N/A, Kashiwa, Japan / Chiba, (8) Kanagawa Cancer Center, Yokohama, Yokohama, (9) Kanazawa University Hospital, Kanazawa, Ishikawa, (10) Kurashiki Central Hospital, Kurashiki, Okayama, (11) National Hospital Organization Kyushu Cancer Center, Fukuoka, Fukuoka, (12) Hiroshima, Hiroshima, PA, (13) National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, (14) Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, (15) West Japan Oncology Group Data Center, Osaka, Osaka, (16) Japan Clinical Oncology Group (JCOG) Data Center/Operations Office, National Cancer Center Hospital, Tokyo, NA, (17) National Cancer Center Hospital East, Tokyo, PA, (18) National Cancer Center Hospital, Tokyo, NA

Makoto Suzuki    -  Contact Me
Kumamoto University Hospital

Ichiro Yoshino    -  Contact Me
Chiba University Hospital

Yasumitsu Moriya    -  Contact Me
Chiba Rosai Hospital

*Kenji Suzuki    -  Contact Me
Juntendo Hospital

Masashi Wakabayashi    -  Contact Me
National Cancer Center East

Hisashi Saji    -  Contact Me
St. Marianna University School of Medicine

keiju aokage    -  Contact Me
N/A

Hiroyuki Ito    -  Contact Me
Kanagawa Cancer Center

Isao Matsumoto    -  Contact Me
Kanazawa University Hospital

Masashi Kobayashi    -  Contact Me
Kurashiki Central Hospital

Tatsuro Okamoto    -  Contact Me
National Hospital Organization Kyushu Cancer Center

Morihito Okada    -  Contact Me
Hiroshima

Motohiro Yamashita    -  Contact Me
National Hospital Organization Shikoku Cancer Center

Norihiko Ikeda    -  Contact Me
Tokyo Medical University Hospital

Shinichiro Nakamura    -  Contact Me
West Japan Oncology Group Data Center

Tomoko Kataoka    -  Contact Me
Japan Clinical Oncology Group (JCOG) Data Center/Operations Office, National Cancer Center Hospital

Masahiro Tsuboi    -  Contact Me
National Cancer Center Hospital East

Shun-ichi Watanabe    -  Contact Me
National Cancer Center Hospital

Makoto Suzuki    -  Contact Me
N/A

Objective. In JCOG0201, we reported the definitions of pathological less invasiveness and elucidated that lung cancer (LC) with a consolidation-to-tumor ratio of ≤0.25 and ≤2 cm in size can be used as a better radiological criterion for a less invasive pathology on preoperative thin-section computed tomography. We have already reported the 5-year safety and efficacy of sublobar resection in the prospective interventional study (JCOG0804/WJOG4507L). The aim of this final analysis was to elucidate the 10-year outcome in JCOG0804/WJOG4507L of sublobar resection for peripheral grand-glass opacity (GGO) dominant LC patients with such radiological features.
Methods. Between May 2009 and April 2011, 333 patients were enrolled from 51 institutions in Japan (median age was 62 at registration) and followed up until May 6, 2021. Of them, sublobar resections were performed in 314 patients (258 wedge resections and 56 segmentectomies), conversion lobectomies were performed in 11 patients, and 8 were ineligible. As an interventional surgical method, wedge resection is performed, and segmentectomy is permitted if the surgical margin is insufficient. The Median follow-up period at the final data cutoff point was 10.1 years.
Results. The 10-year RFS and OS for the 314 patients with sublobar resections were 98.6 % (95% CI, 96.2 – 99·5%) and 98.5% (95% CI, 96.1 – 99.4%), respectively. There was one local recurrence at resection margin. Among the patients, secondary cancers were observed in 43 patients (13.7%: 95% CI, 10.1 -18.0%), of them 19 were secondary LCs (6.1%: 95% CI, 3.7-9.3%).
Conclusions. The long-term results from JCOG0804/WJOG4507L suggested that sublobar resection for peripheral GGO dominant LC patients is a surgical procedure that can fully cured them. The indication of other treatment options would be further investigated.

Lung Cancer