Small peripheral lung adenocarcinoma: CT and histopathologic characteristics and prognostic implications

Cancer Imaging

Volumn 11, Issue 1, 2011, Pages 237-246

  Chu, Zhi Gang ^a   Yanga, Zhi Gang ^a   Shao, Heng ^a   Zhu, Zhi Yu ^b   Deng, Wen ^a   Tang, Shi Si ^a   Chen, Jing ^a   Li, Yuan ^a  

^a SICHUAN UNIVERSITY   (China)

^b SICHUAN UNIVERSITY   (China)

Author keywords

Adenocarcinoma; CT; Histopathology; Lung neoplasms; Prognosis

Indexed keywords

CANCER DIAGNOSIS; CANCER GROWTH; CANCER SCREENING; CANCER STAGING; COMPUTER ASSISTED TOMOGRAPHY; HISTOPATHOLOGY; HUMAN; LOW ENERGY RADIATION; LUNG ADENOCARCINOMA; LUNG ALVEOLUS CELL CARCINOMA; LUNG BIOPSY; LUNG LOBECTOMY; LUNG RESECTION; LUNG SMALL CELL CANCER; LYMPH NODE METASTASIS; MICROSCOPY; PERIPHERAL LUNG LESION; PROGNOSIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; THORAX RADIOGRAPHY; TUMOR VOLUME;

ADENOCARCINOMA; HUMANS; LUNG NEOPLASMS; PROGNOSIS; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84855468798     PISSN: None     EISSN: 14707330     Source Type: Journal    
DOI: 10.1102/1470-7330.2011.0033     Document Type: Review

References (97)

1. Heelan RT, Flehinger BJ, Melamed MR, et al. Non-small-cell lung cancer: results of the New York screening program. Radiology 1984; 151: 289-93. (Pubitemid 14129747)
2. Melamed MR, Flehinger BJ, Zaman MB, Heelan RT, Perchick WA, Martini N. Screening for early lung cancer: results of the Memorial Sloan-Kettering study in New York. Chest 1984; 86: 44-53. doi:10.1378/chest.86.1.44. (Pubitemid 14088027)
3. Sone S, Li F, Yang ZG, et al. Characteristics of small lung cancers invisible on conventional chest radiography and detected by population based screening using spiral CT. Br J Radiol 2000; 73: 137-45. (Pubitemid 30179220)
4. Sone S, Li F, Yang ZG, et al. Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer 2001; 84: 25-32. doi:10.1054/bjoc.2000.1531. (Pubitemid 32102499)
5. Diederich S, Wormanns D, Semik M, et al. Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology 2002; 222: 773-81. doi:10.1148/radiol.2223010490. (Pubitemid 34215229)
6. Menezes RJ, Roberts HC, Paul NS, et al. Lung cancer screening using low-dose computed tomography in at-risk individuals: the Toronto experience. Lung Cancer 2010; 67: 177-83. doi:10.1016/j.lungcan.2009.03.030.
7. Henschke CI, McCauley DI, Yankelevitz DF, et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999; 354: 99-105. doi:10.1016/S0140-6736(99)06093-6. (Pubitemid 29313143)
8. Swensen SJ, Jett JR, Sloan JA, et al. Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med 2002; 165: 508-13. (Pubitemid 34165474)
9. Swensen SJ, Jett JR, Hartman TE, et al. Lung cancer screening with CT: Mayo Clinic experience. Radiology 2003; 226: 756-61. doi:10.1148/radiol. 2263020036. (Pubitemid 36259152)
10. Pastorino U. Lung cancer screening. Br J Cancer 2010; 102: 1681-6. doi:10.1038/sj.bjc.6605660.
11. Henschke CI, Yankelevitz DF. CT screening for lung cancer: update 2007. Oncologist 2008; 13: 65-78. doi:10.1634/theoncologist.2007-0153. (Pubitemid 351206697)
12. Xu DM, Gietema H, de Koning H, et al. Nodule management protocol of the NELSON randomised lung cancer screening trial. Lung Cancer 2006; 54: 177-84. doi:10.1016/j.lungcan.2006.08.006. (Pubitemid 44802721)
13. Henschke CI, Yankelevitz DF, et al. International Early Lung Cancer Action Program Investigators. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006; 355: 1763-71. (Pubitemid 44631359)
14. Sone S, Nakayama T, Honda T, et al. Long-term follow-up study of a population-based 1996-1998 mass screening programme for lung cancer using mobile low-dose spiral computed tomography. Lung Cancer 2007; 58: 329-41. doi:10.1016/j.lungcan.2007.06.022. (Pubitemid 350051508)
15. Brooks DR, Austin JH, Heelan RT, et al. Peripheral versus central lung cancer: influence of type of cigarette. Cancer Epidemiol Biomarkers Prev 2005; 14: 576-81. doi:10.1158/1055-9965.EPI-04-0468. (Pubitemid 40489198)
16. Travis WD, Travis LB, Devesa SS. Lung cancer. Cancer 1995; 75: 191-202. doi:10.1002/1097-0142(19950101)75:1+5191::AID-CNCR282075130743.0.CO;2-Y.
17. Auerbach O, Garfinkel L. The changing pattern of lung carcinoma. Cancer 1991; 68: 1973-7. doi:10.1002/1097-0142(19911101)68:951973::AID- CNCR282068092143.0.CO;2-Z.
18. Sone S, Takashima S, Li F, et al. Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 1998; 351: 1242-5. doi:10.1016/S0140-6736(97)08229-9. (Pubitemid 28181964)
19. Nakata M, Saeki H, Takata I, et al. Focal ground-glass opacity detected by low-dose helical CT. Chest 2002; 121: 1464. doi:10.1378/chest.121.5.1464.
20. Sagawa M, Saito Y, Takahashi S, et al. Clinical and prognostic assessment of patients with resected small peripheral lung cancer lesions. Cancer 1990; 66: 2653-7. doi:10.1002/1097-0142(19901215)66:1252653::AID-CNCR282066123143.0. CO;2-U.
21. Kondo T, Yamada K, Noda K, Nakayama H, Kameda Y. Radiologic-prognostic correlation in patients with small pulmonary adenocarcinomas. Lung Cancer 2002; 36: 49-57. doi:10.1016/S0169-5002(01)00448-2. (Pubitemid 34224895)
22. Sakurai H, Maeshima A, Watanabe S, et al. Grade of stromal invasion in small adenocarcinoma of the lung: histopathological minimal invasion and prognosis. Am J Surg Path 2004; 28: 198-206. (Pubitemid 38124728)
23. Aoki T, Tomoda Y, Watanabe H, et al. Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival. Radiology 2001; 220: 803-9. doi:10.1148/radiol.2203001701. (Pubitemid 32799993)
24. Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997; 111: 1710-17. doi:10.1378/chest.111.6.1710. (Pubitemid 27260107)
25. Takise A, Kodama T, Shimosato Y, Watanabe S, Suemasu K. Histopathologic prognostic factors in adenocarcinomas of the peripheral lung less than 2 cm in diameter. Cancer 1988; 61: 2083-8. doi:10.1002/1097-0142(19880515)61:1052083:: AID-CNCR282061102543.0.CO;2-U.
26. Read RC, Schaefer R, North N, Walls R. Diameter, cell type and survival in stage I primary non-small-cell lung cancer. Arch Surg 1988; 123: 446-9.
27. Suzuki K, Yokose T, Yoshida J, et al. Prognostic significance of the size of center fibrosis in peripheral adenocarcinoma of the lung. Ann Thorac Surg 2000; 69: 893-7. doi:10.1016/S0003-4975(99)01331-4. (Pubitemid 30184718)
28. Patz EF, Jr. Rossi S, Harpole DH, Jr. Herndon JE, Goodman PC. Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer. Chest 2000; 117: 1568-71. doi:10.1378/chest.117.6.1568. (Pubitemid 30413345)
29. Eto T, Suzuki H, Honda A, Nagashima Y. The changes of the stromal elastotic framework in the growth of peripheral lung adenocarcinomas. Cancer 1996; 77: 646-56. doi:10.1002/(SICI)1097-0142(19960215)77:45646::AID-CNCR1043.3. CO;2-Q. (Pubitemid 26055389)
30. Kim EA, Johkoh T, Lee KS, et al. Quantification of ground-glass opacity on high-resolution CT of small peripheral adenocarcinoma of the lung: pathologic and prognostic implications. AJR Am J Roentgenol 2001; 177: 1417-22. (Pubitemid 33081493)
31. Higashiyama M, Kodama K, Yokouchi H, et al. Prognostic value of bronchioloalveolar carcinoma component of small lung adenocarcinoma. Ann Thorac Surg 1999; 68: 2069-73. doi:10.1016/S0003-4975(99)01064-4. (Pubitemid 30027827)
32. Watanabe S, Watanabe T, Arai K, Kasai T, Haratake J, Urayama H. Results of wedge resection for focal bronchioloalveolar carcinoma showing pure ground-glass attenuation on computed tomography. Ann Thorac Surg 2002; 73: 1071-5. doi:10.1016/S0003-4975(01)03623-2. (Pubitemid 34275880)
33. Jett JR, Midthun DE. Commentary: CT screening for lung cancer -caveat emptor. Oncologist 2008; 13: 439-44. doi:10.1634/theoncologist.2008-0027. (Pubitemid 351679924)
34. Bach PB, Kelley MJ, Tate RC, McCrory DC. Screening for lung cancer: a review of the current literature. Chest 2003; 123: 72S-82S. doi:10.1378/chest. 123.1-suppl.72S. (Pubitemid 36135704)
35. Aberle DR, Brown K. Lung cancer screening with CT. Clin Chest Med 2008; 29: 1-14. doi:10.1016/j.ccm.2007.12.001. (Pubitemid 351220913)
36. Soda H, Tomita H, Kohno S, Oka M. Limitation of annual screening chest radiography for the diagnosis of lung cancer. Cancer 1993; 72: 2341-6. doi:10.1002/1097-0142(19931015)72:852341::AID-CNCR282072080943.0.CO;2-A. (Pubitemid 23299596)
37. Yang ZG, Sone S, Li F, et al. Detection of small peripheral lung cancer by digital chest radiography: performance of unprocessed versus unsharp mask-processed images. Acta Radiol 1999; 40: 505-9. doi:10.3109/ 02841859909175575. (Pubitemid 129567262)
38. Heitzman ER, Markarian B, Raasch BN, Carsky EW, Lane EJ, Berlow ME. Pathways of tumor spread through the lung: radiologic correlations with anatomy and pathology. Radiology 1982; 144: 3-14. (Pubitemid 12050804)
39. Kaneko M, Eguchi K, Ohmatsu H, et al. Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. Radiology 1996; 201: 798-802.
40. Takashima S, Sone S, Li F, Maruyama Y, Hasegawa M, Kadoya M. Indeterminate solitary pulmonary nodules revealed at population-based CT screening of lung: using first follow-up diagnostic CT to differentiate benign and malignant lesions. AJR Am J Roentgenol 2003; 180: 1255-63. (Pubitemid 36504611)
41. New York Early Lung Cancer Action Project Investigators. CT Screening for lung cancer: diagnoses resulting from the New York Early Lung Cancer Action Project. Radiology 2007; 243: 239-49.
42. Yang ZG, Sone S, Takashima S, et al. High-resolution CT analysis of small peripheral lung adenocarcinomas revealed on screening helical CT. AJR Am J Roentgenol 2001; 176: 1399-407. (Pubitemid 32510250)
43. Yang Z, Sone S, Takashima S, Li F, Honda T, Yamanda T. Small peripheral carcinomas of lung: thin-section CT and pathologic correlation. Eur Radiol 1999; 9: 1819-25. doi:10.1007/s003300050929.
44. Yang ZG, Sone S, Li F, et al. Visibility of small peripheral lung cancers on chest radiographs: influence of densitometric parameters, CT values and tumor type. Br J Radiol 2001; 74: 32-41. (Pubitemid 32156628)
45. Tsubamoto M, Kuriyama K, Kido S, et al. Detection of lung cancer on chest radiographs: analysis on the basis of size and extent of ground-glass opacity at thin-section CT. Radiology 2002; 224: 139-44. doi:10.1148/radiol.2241001445. (Pubitemid 34680385)
46. Austin JH, Romney BM, Goldsmith LS. Missed bronchogenic carcinoma: radiographic findings in 27 patients with a potentially resectable lesion evident in retrospect. Radiology 1992; 182: 115-22.
47. Noguchi M, Morikawa A, Kawasaki M, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer 1995; 75: 2844-52. doi:10.1002/1097-0142(19950615)75:12〈2844::AID-CNCR2820751209〉3.0. CO;2-#.
48. Nakazono T, Sakao Y, Yamaguchi K, Imai S, Kumazoe H, Kudo S. Subtypes of peripheral adenocarcinoma of the lung: differentiation by thin-section CT. Eur Radiol 2005; 15: 1563-8. doi:10.1007/s00330-004-2595-7. (Pubitemid 41102349)
49. Saito H, Kameda Y, Masui K, et al. Correlations between thin-section CT findings, histopathological and clinical findings of small pulmonary adenocarcinomas. Lung Cancer 2011; 71: 137-43. doi:10.1016/j.lungcan.2010.04. 018.
50. Henschke CI, Yankelevitz DF, Mirtcheva R, et al. CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol 2002; 178: 1053-7. (Pubitemid 34411393)
51. Park CM, Goo JM, Lee HJ, Lee CH, Chun EJ, Im JG. Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up. Radiographics 2007; 27: 391-408. doi:10.1148/rg.272065061.
52. Jang HJ, Lee KS, Kwon OJ, Rhee CH, Shim YM, Han J. Bronchioloalveolar carcinoma: focal area of ground-glass attenuation at thin-section CT as an early sign. Radiology 1996; 199: 485-8. (Pubitemid 26122000)
53. Ground-glass opacity on thin-section CT: value in differentiating subtypes of adenocarcinoma of the lung. AJR Am J Roentgenol 1999; 173: 465-9.
54. Suzuki K, Kusumoto M, Watanabe S, Tsuchiya R, Asamura H. Radiologic classification of small adenocarcinoma of the lung: radiologic-pathologic correlation and its prognostic impact. Ann Thorac Surg 2006; 81: 413-9. doi:10.1016/j.athoracsur.2005.07.058. (Pubitemid 43120527)
55. Takashima S, Li F, Maruyama Y, et al. Discrimination of subtypes of small adenocarcinoma in the lung with thin-section CT. Lung Cancer 2002; 36: 175-82. doi:10.1016/S0169-5002(01)00461-5. (Pubitemid 34296559)
56. Nakahara R, Yokose T, Nagai K, Nishiwaki Y, Ochiai A. Atypical adenomatous hyperplasia of the lung: a clinicopathological study of 118 cases including cases with multiple atypical adenomatous hyperplasia. Thorax 2001; 56: 302-5. doi:10.1136/thorax.56.4.302. (Pubitemid 32269811)
57. Kawakami S, Sone S, Takashima S, et al. Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features. Eur J Radiol 2001; 11: 811-13.
58. Carter D, Vazquez M, Flieder DB, et al. Comparison of pathologic findings of baseline and annual repeat cancers diagnosed on CT screening. Lung Cancer 2007; 56: 193-9. doi:10.1016/j.lungcan.2006.12.001. (Pubitemid 46590482)
59. Carey FA, Wallace WA, Fergusson RJ, Kerr KM, Lamb D. Alveolar atypical hyperplasia in association with primary pulmonary adenocarcinoma: a clinicopathological study of 10 cases. Thorax 1992; 47: 1041-3. doi:10.1136/thx.47.12.1041. (Pubitemid 23011022)
60. Kodama T, Biyajima S, Watanabe S, Shimosato Y. Morphometric study of adenocarcinomas and hyperplastic epithelial lesions in the peripheral lung. Am J Clin Pathol 1986; 85: 146-51. (Pubitemid 16167112)
61. Takigawa N, Segawa Y, Nakata M, et al. Clinical investigation of atypical adenomatous hyperplasia of the lung. Lung Cancer 1999; 25: 115-21. doi:10.1016/S0169-5002(99)00055-0. (Pubitemid 29333090)
62. Weng SY, Tsuchiya E, Kasuga T, Sugano H. Incidence of atypical bronchioloalveolar cell hyperplasia of the lung: relation to histological subtypes of lung cancer. Virchows Arch A Pathol Anat Histopathol 1992; 420: 463-71. doi:10.1007/BF01600250.
63. Shimizu K, Yamada K, Saito H, et al. Surgically curable peripheral lung carcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival. Chest 2005; 127: 871-8. doi:10.1378/chest.127.3.871. (Pubitemid 40775518)
64. Fujikawa A, Takiguchi Y, Mizuno S, et al. Lung cancer screening -comparison of computed tomography and X-ray. Lung Cancer 2008; 61: 195-201. doi:10.1016/j.lungcan.2007.12.010.
65. Gail MH, Eagan RT, Feld R, et al. Prognostic factors in patients with resected stage I non-small cell lung cancer: a report from the lung cancer study group. Cancer 1984; 54: 1802-13. doi:10.1002/1097-0142(19841101)54:9〈1802: :AID-CNCR2820540908〉3.0.CO;2-4. (Pubitemid 14020608)
66. Sakao Y, Miyamoto H, Sakuraba M, et al. Prognostic significance of a histologic subtype in small adenocarcinoma of the lung: the impact of nonbronchioloalveolar carcinoma components. Ann Thorac Surg 2007; 83: 209-14. doi:10.1016/j.athoracsur.2006.07.051. (Pubitemid 44917878)
67. Maeshima AM, Tochigi N, Yoshida A, Asamura H, Tsuta K, Tsuda H. Histological scoring for small lung adenocarcinomas 2 cm or less in diameter: a reliable prognostic indicator. J Thorac Oncol 2010; 5: 333-9. doi:10.1097/JTO.0b013e3181c8cb95.
68. Inoue M, Takakuwa T, Minami M, et al. Clinicopathologic factors influencing postoperative prognosis in patients with small-sized adenocarcinoma of the lung. J Thorac Cardiovasc Surg 2008; 135: 830-6. doi:10.1016/j.jtcvs. 2007.10.034. (Pubitemid 351417932)
69. Ohta Y, Shimizu Y, Kobayashi T, et al. Pathologic and biological assessment of lung tumors showing ground-glass opacity. Ann Thorac Surg 2006; 81: 1194-7. doi:10.1016/j.athoracsur.2005.10.037.
70. Ohde Y, Nagai K, Yoshida J, et al. The proportion of consolidation to ground-glass opacity on high resolution CT is a good predictor for distinguishing the population of non-invasive peripheral adenocarcinoma. Lung Cancer 2003; 42: 303-10. doi:10.1016/j.lungcan.2003.07.001. (Pubitemid 37468543)
71. Anami Y, Iijima T, Suzuki K, et al. Bronchioloalveolar carcinoma (lepidic growth) component is a more useful prognostic factor than lymph node metastasis. J Thorac Oncol 2009; 4: 951-8. doi:10.1097/JTO.0b013e3181ad8631.
72. Kodama K, Higashiyama M, Yokouchi H, et al. Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning. Lung Cancer 2001; 33: 17-25. doi:10.1016/S0169-5002(01)00185-4. (Pubitemid 32586777)
73. Takashima S, Maruyama Y, Hasegawa M, et al. Prognostic significance of high-resolution CT findings in small peripheral adenocarcinoma of the lung: a retrospective study on 64 patients. Lung Cancer 2002; 36: 289-95. doi:10.1016/S0169-5002(01)00489-5. (Pubitemid 34497129)
74. Vazquez M, Carter D, Brambilla E, et al. International Early Lung Cancer Action Program Investigators. Solitary and multiple resected adenocarcinomas after CT screening for lung cancer: histopathologic features and their prognostic implications. Lung Cancer 2009; 64: 148-54. doi:10.1016/j.lungcan. 2008.08.009.
75. Sakao Y, Nakazono T, Sakuragi T, Natsuaki M, Itoh T. Predictive factors for survival in surgically resected clinical IA peripheral adenocarcinoma of the lung. Ann Thorac Surg 2004; 77: 1157-61. doi:10.1016/j.athoracsur.2003.09.055. (Pubitemid 38452337)
76. Sakao Y, Nakazono T, Tomimitsu S, et al. Lung adenocarcinoma can be subtyped according to tumor dimension by computed tomography mediastinal-window setting. Additional size criteria for clinical T1 adenocarcinoma. Eur J Cardiothorac Surg 2004; 26: 1211-15. doi:10.1016/j.ejcts.2004.08.021. (Pubitemid 39487472)
77. Shimosato Y, Suzuki A, Hashimoto T, et al. Prognostic implications of fibrotic focus (scar) in small peripheral lung cancers. Am J Surg Pathol 1980; 4: 365-73. doi:10.1097/00000478-198008000-00005. (Pubitemid 10035269)
78. Okudera K, Kamata Y, Takanashi S, et al. Small adenocarcinoma of the lung: prognostic significance of central fibrosis chiefly because of its association with angiogenesis and lymphangiogenesis. Pathol Int 2006; 56: 494-502. doi:10.1111/j.1440-1827.2006.01997.x. (Pubitemid 44258850)
79. Usuda K, Saito Y, Sagawa M, et al. Tumor doubling time and prognostic assessment of patients with primary lung cancer. Cancer 1994; 74: 2239-44. doi:10.1002/1097-0142(19941015)74:8〈2239::AID-CNCR2820740806〉3.0. CO;2-P. (Pubitemid 24322277)
80. Arai T, Kuroishi T, Saito Y, Kurita Y, Naruke T, Kaneko M. Tumor doubling time and prognosis in lung cancer patients: evaluation from chest films and clinical follow-up study. Japanese Lung Cancer Screening Research Group. Jpn J Clin Oncol 1994; 24: 199-204.
81. Geddes DM. The natural history of lung cancer: a review based on rates of tumour growth. Br J Dis Chest 1979; 73: 1-17. doi:10.1016/0007-0971(79)90002-0. (Pubitemid 9097173)
82. Hasegawa M, Sone S, Takashima S, et al. Growth rate of small lung cancers detected on mass CT screening. Br J Radiol 2000; 73: 1252-9. (Pubitemid 32123826)
83. Aoki T, Nakata H, Watanabe H, et al. Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time. AJR Am J Roentgenol 2000; 174: 763-8. (Pubitemid 30126259)
84. Wang JC, Sone S, Feng L, et al. Rapidly growing small peripheral lung cancers detected by screening CT: correlation between radiological appearance and pathological features. Br J Radiol 2000; 73: 930-7.
85. Libby DM, Smith JP, Altorki NK, Pasmantier MW, Yankelevitz D, Henschke CI. Managing the small pulmonary nodule discovered by CT. Chest 2004; 125: 1522-9. doi:10.1378/chest.125.4.1522. (Pubitemid 38501373)
86. Sugi K, Kobayashi S, Sudou M, Sakano H, Matsuda E, Okabe K. Long-term prognosis of video-assisted limited surgery for early lung cancer. Eur J Cardiothorac Surg 2010; 37: 456-60.
87. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995; 60: 615-23. doi:10.1016/0003-4975(95)00537-U.
88. Fukui T, Sakakura N, Mori S, et al. Controversy about small peripheral lung adenocarcinomas: how should we manage them? J Thorac Oncol 2007; 2: 546-52. doi:10.1097/JTO.0b013e318060d30d. (Pubitemid 47171811)
89. Yoshikawa K, Tsubota N, Kodama K, Ayabe H, Taki T, Mori T. Prospective study of extended segmentectomy for small lung tumors: the final report. Ann Thorac Surg 2002; 73: 1055-8. doi:10.1016/S0003-4975(01)03466-X. (Pubitemid 34275876)
90. Okada M, Nishio W, Sakamoto T, et al. Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg 2005; 129: 87-93. doi:10.1016/j.jtcvs.2004.04.030. (Pubitemid 40038100)
91. Yamato Y, Koike T, Yoshiya K, Shinohara H, Toyabe S. Results of surgical treatment for small (2 cm or under) adenocarcinomas of the lung. Surg Today 2008; 38: 109-14. doi:10.1007/s00595-007-3594-5. (Pubitemid 351197900)
92. Nakamura H, Saji H, Ogata A, Saijo T, Okada S, Kato H. Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates for wedge resection. Lung Cancer 2004; 44: 61-8. doi:10.1016/j. lungcan.2003.09.025. (Pubitemid 38317262)
93. Sagawa M, Higashi K, Usuda K, et al. Curative wedge resection for non-invasive bronchioloalveolar carcinoma. Tohoku J Exp Med 2009; 217: 133-7. doi:10.1620/tjem.217.133.
94. Yamada S, Kohno T. Video-assisted thoracic surgery for pure ground-glass opacities 2 cm or less in diameter. Ann Thorac Surg 2004; 77: 1911-15. doi:10.1016/j.athoracsur.2003.12.040. (Pubitemid 38686556)
95. Ohtsuka T, Watanabe K, Kaji M, Naruke T, Suemasu K. A clinicopathological study of resected pulmonary nodules with focal pure ground-glass opacity. Eur J Cardiothorac Surg 2006; 30: 160-3. doi:10.1016/j.ejcts.2006.03.058. (Pubitemid 43850329)
96. Nakayama H, Yamada K, Saito H, et al. Sublobar resection for patients with peripheral small adenocarcinomas of the lung: surgical outcome is associated with features on computed tomographic imaging. Ann Thorac Surg 2007; 84: 1675-9. doi:10.1016/j.athoracsur.2007.03.015. (Pubitemid 47588103)
97. Rami-Porta R, Tsuboi M. Sublobar resection for lung cancer. Eur Respir J 2009; 33: 426-35. doi:10.1183/09031936.00099808.