Virtual-assisted lung mapping in sublobar resection of small pulmonary nodules, long-term results
H. Yamaguchi, Masaaki Sato, Kazumichi Yamamoto, Keiko Ueda, Hiroshi Date, Toyofumi F. Chen‐Yoshikawa, Yoshito Yamada, Junko Tokuno, Masahiro Yanagiya, F. Kojima, Nobuyuki Yoshiyasu, Masashi Kobayashi, Yasuhiro Nakashima, Terumoto Koike, Jin Sakamoto, Shinji Kosaka, Ryuta Fukai, Tomoki Nishida, Hiroaki Sakai, Shinji Shinohara, Masaru Takenaka, Fumihiro Tanaka, Kenji Misawa, Jun Nakajima
Abstract
OBJECTIVES: The short-term efficacy of virtual-assisted lung mapping (VAL-MAP), a preoperative bronchoscopic multi-spot lung-marking technique, has been confirmed in 2 prospective multicentre studies. The objectives of this study were to analyse the local recurrence and survival of patients enrolled in these studies, long-term. METHODS: Of the 663 patients enrolled in the 2 studies, 559 patients' follow-up data were collected. After excluding those who did not undergo VAL-MAP, whose resection was not for curative intent, who underwent concurrent resection without VAL-MAP, or who eventually underwent lobectomy instead of sublobar resection (i.e. wedge resection or segmentectomy), 422 patients were further analysed. RESULTS: Among 264 patients with primary lung cancer, the 5-year local recurrence-free rate was 98.4%, and the 5-year overall survival (OS) rate was 94.5%. Limited to stage IA2 or less (≤2 cm in diameter; n = 238, 90.1%), the 5-year local recurrence-free and OS rates were 98.7% and 94.8%, respectively. Among 102 patients with metastatic lung tumours, the 5-year local recurrence-free rate was 93.8% and the 5-year OS rate was 81.8%. Limited to the most common (colorectal) cancer (n = 53), the 5-year local recurrence-free and OS rates were 94.9% and 82.3%, respectively. CONCLUSIONS: VAL-MAP, which is beneficial in localizing small barely palpable pulmonary lesions and determining the appropriate resection lines, was associated with reasonable long-term outcomes. SUBJ COLLECTION: 152, 1542.