Determination of safe margin in the surgical pathologic specimens of non-small cell carcinoma of the lung

Background and Aim: Local recurrences of the
tumor at the surgical margin are serious problems
in pulmonary resections for lung cancer. The aim of
this study is to determine the involved margins and
safe distances of the resection sites from tumor for
prevention of local recurrences. Material and Methods:
In this prospective study, 66 patients operated for
non-small cell lung carcinoma (NSCLC) from Jan
2006 to Sep 2008 were evaluated. After performing
pulmonary resections, multiple biopsies were taken
up from 5 mm (A), 10 mm (B), 15 mm (C), and 20
mm (D) distance from tumor. The specimens were
studied histopathologically. Results: From a total of 66
patients with NSCLC admitted to our referral hospital,
25 (38%) had adenocarcinoma, 18 (27.3%) squamous
cell carcinoma, 5 (7.5%) large cell carcinoma, 4 (6%)
bronchoalveolar cell carcinoma, 4 (6%) adenoid cystic
carcinoma, 3 (4.6%) malignant carcinoid tumor and 7
(10.6%) had metastasis. The most common symptoms
were dyspnea and cough. Histopathologically tumor
positive margins were found in 84.8% (A), 10.6%
(B), 4.5% (C), and 0% (D). There was a significant
statistically difference between tumor involvement
at distances 5 mm (A) versus 10-20 mm (B-D) (P
<0.001). Conclusion: A 20 mm distance from the
gross tumor is considered as a safe surgical margin
in any type of malignant pulmonary resections
for prevention of local surgical recurrences if there
was no pathologic examination before surger