Frozen-section diagnosis of small adenocarcinoma of the lung for intentional limited surgery

Purpose. To determine if Noguchi's classification can be evaluated accurately by frozen-section diagnosis before limited surgery. Methods. We performed frozen-section diagnosis in 31 of 343 patients who underwent excision of primary lung cancer at our hospital between 1993 and 2004. All 31 patients had pulmonary adenocarcinoma, with a tumor diameter of ≦20 mm. There were 20 men and 11 women, ranging in age from 42 to 79 years (mean, 63.2 years). We assessed the rate of correct Noguchi's classification by categorizing all lesions into the following three groups on the basis of tumor diameter: ≤10 mm, 11-15 mm, and 16-20 mm. Results. The overall rate of correct frozen-section diagnosis during surgery was 67.7%; being 100%, 41.7%, and 70% in the ≦10 mm, 11-15 mm, and 16-20 mm groups, respectively. Conclusion. Limited surgery for primary lung cancer can be performed when the tumor diameter is ≦10 mm, by confirming it as either type A or B according to Noguchi's classification, using frozen-section diagnosis. Thus, examination of frozen sections might be an important diagnostic procedure before intentional limited surgery for lung cancer.