The pre-and minimally invasive types of lung cancer are adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA). The purpose of the study was to look into the safety and survival outcomes of different modalities of surgical resection in a large group of patients with AIS/MIA. Patients with lung AIS/MIA who underwent surgery between 2012 and 2017 had their medical records evaluated retrospectively. The researchers looked into clinical characteristics, surgery types and complications, recurrence-free survival, and overall survival. A total of 1,644 participants were enrolled in the study (422 AIS and 1222 MIA). Patients undergoing wedge resection (1.0%) had a lower overall surgical complication rate than patients undergoing segmentectomy (3.3%) or lobectomy (5.6%). In the wedge resection group, grade ≥ 3 problems occurred in 0.1% of patients and a similar proportion of patients in the segmentectomy (1.5%) and lobectomy groups (1.5%). No lymph node metastases were seen. The recurrence-free survival rate was 100% after five years. The overall 5-year survival rate for the total cohort was 98.8%, and the wedge resection group (98.8%), segmentectomy group (98.2%), and lobectomy group (99.4%).
Sublobar resection, particularly wedge resection without lymph node dissection, may be the suggested surgical method for people with AIS/MIA. Postoperative follow-up intervals may be extended if there are no risk concerns. Further research is needed to confirm these conclusions.
Reference:www.jtcvs.org/article/S0022-5223(20)33299-2/fulltext