Margin Width of Resected Lepidic Lung Cancer Does Not Affect Recurrence After Sublobar Resection.

BACKGROUND: A sufficient resection margin is required for the sublobar resection of lung cancers. However, the width of the resection margin may not be important in lepidic adenocarcinoma, because such tumors are non- or minimally invasive. The purpose of this study was to determine the effect of resection margin width on the outcome of patients with lepidic-dominant adenocarcinoma after sublobar resection.

METHODS: This study included 133 patients with small (≤2 cm), clinical N0M0 lung cancer who underwent sublobar resection with curative intent. The patients were divided into 4 groups: Group A, lepidic tumor with margin/tumor ratio <1; Group B, lepidic tumor with margin/tumor ratio ≥1; Group C, non-lepidic tumor with margin/tumor ratio <1; Group D, non-lepidic tumor with margin/tumor ratio ≥1. The clinicopathological features and survival outcomes between Group A and B patients, and between Group C and D patients were compared.

RESULTS: The 5-year recurrence-free survival (RFS) rates of Group A and B patients were both 100%. The 5-year RFS rates of Group C and D patients were 49.9 and 97.1%, respectively (p = 0.009). By multivariate analysis, the margin/tumor ratio was a significant independent factor for recurrence in patients with non-lepidic tumors (hazard ratio = 0.157, 95% confidence interval 0.027-0.898; p = 0.037).

CONCLUSIONS: Tumor recurrence after sublobar resection is not associated with short resection margins in patients with lepidic tumors. However, a short resection margin is a significant risk factor for recurrence in patients with non-lepidic tumors.