Indications for sublobar resection of clinical-stage IA radiological pure-solid lung adenocarcinoma

Abstract Objectives The aim of this study was to identify clinical factors associated with lepidic growth in resected clinical-stage IA radiological pure-solid lung adenocarcinoma for identifying a possible sublobar resection candidate in the population. Methods Clinicopathological data was reviewed for 200 surgically resected clinical-stage IA pure-solid lung adenocarcinomas. Radiological pure-solid tumor was defined as a tumor without a ground glass opacity component, i.e., a consolidation tumor ratio equal to 1.0. Lepidic predominant adenocarcinoma (LPA) included adenocarcinomas in situ, minimally invasive adenocarcinomas and lepidic predominant invasive adenocarcinomas. Results Fifty-seven (29%) patients showed LPA. The 5-year overall survival (OS) of clinical-stage IA pure-solid adenocarcinoma was 83.4% and that of LPA and non-LPA was 98.1% vs. 76.6% (p=0.0012). A multivariate analysis revealed that maximum standardized uptake value (SUVmax) was an independently significant variable of LPA (p3.3 (62.7% vs. 82.9%, p=0.0281). Conclusions Higher SUVmax value may be useful for identifying patients with clinical-stage IA radiological pure-solid lung adenocarcinoma in whom sublobar resection should not be considered, even if technically feasible.