Virtual-assisted lung mapping in sublobar resection of small pulmonary nodules, long-term results

• Published in: European journal of cardio-thoracic surgery 2022-03, Vol.61 (4), p.761-768
• Main Authors: Yamaguchi, Hirokazu, Sato, Masaaki, Yamamoto, Kazumichi, Ueda, Keiko, Date, Hiroshi, Chen-Yoshikawa, Toyofumi, Yamada, Yoshito, Tokuno, Junko, Yanagiya, Masahiro, Kojima, Fumitsugu, Yoshiyasu, Nobuyuki, Kobayashi, Masashi, Nakashima, Yasuhiro, Koike, Terumoto, Sakamoto, Jin, Kosaka, Shinji, Fukai, Ryuta, Nishida, Tomoki, Sakai, Hiroaki, Shinohara, Shinji, Takenaka, Masaru, Tanaka, Fumihiro, Misawa, Kenji, Nakajima, Jun
• Format: Article
• Language: English
• Subjects: Bronchoscopy - methods; Humans; Lung - surgery; Lung Neoplasms; Multiple Pulmonary Nodules - surgery; Neoplasm Staging; Pneumonectomy - methods; Prospective Studies; Retrospective Studies
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezab421

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 Suspicious small pulmonary nodules are being found more often, with the development and widespread use of high-resolution computed tomography (CT).