TITLE

Sublobar resections in stage IA non-small cell lung cancer: segmentectomies result in significantly better cancer-related survival than wedge resections

AUTHOR(S)
Sienel, Wulf; Dango, Sebastian; Kirschbaum, Andreas; Cucuruz, Beatrix; Hörth, Wolfram; Stremmel, Christian; Passlick, Bernward
PUB. DATE
April 2008
SOURCE
European Journal of Cardio-Thoracic Surgery;Apr2008, Vol. 33 Issue 4, p728
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: Sublobar resections spare pulmonary function and offer a method of increasing resection rates in patients with lung cancer and limited functional operability. Previous studies demonstrated an increased local recurrence rate following wedge resections compared to segmentectomies in stage IA non-small cell lung cancer (NSCLC). However, a prognostic impact of this observation has never been shown and is still under debate. Therefore, this study has been performed to analyse the cancer-related survival of sublobar resections in stage IA patients. Methods: Over a 17-year period 87 patients underwent sublobar complete resection (R0) of stage IA NSCLC via thoracotomy. Sublobar resection was reserved for patients with cardiopulmonary impairment. Wedge resections with selective lymphadenectomy were performed in 31 patients (36%) and segmentectomies with systematic lymphadenectomy in 56 patients (64%). Patient characteristics, functional parameters, tumour specifics and follow-up duration were analysed concerning their distribution between the two groups. Kaplan–Meier curves were compared and possible joint effects between prognostic parameters were analysed by multivariate Cox regression analysis. Results: The median follow-up duration was 45 months. There was no significant difference between the two groups in gender (p =0.11), age (p =0.08), American Society of Anesthesiology physical performance status (ASA)-score (p =0.32), forced expiratory volume in 1s FEV1 (p =0.08), tumour size (p =0.30), histology (p =0.17), grading (p =0.12), complication rate (p =0.15) and follow-up duration (p =0.29). The mean number of dissected lymph nodes in segmentectomies (12±6) was higher than in wedge resections (6±3) (p =0.0001). The 5-year survival rate was 63%. There were significantly less locoregional recurrences (p =0.001), an equal distribution of distant metastases (p =0.53) and a better cancer-related survival (p =0.016) following segmentectomies compared to wedge resections. Cox regression analysis showed that the prognostic effect of the resection type was independent from gender, age, ASA-score, respiratory function, tumour size, tumour histology, grading and number of dissected lymph nodes (p =0.04, relative risk 1.16). Conclusions: Studies investigating survival after sublobar resection of stage IA NSCLC should always distinguish between anatomical segmentectomies and wedge resections. If limited functional operability requires a sublobar resection of stage IA NSCLC, segmentectomy with systematic lymphadenectomy should be preferred.
ACCESSION #
31304701

 

Related Articles

  • Induction chemoradiation therapy followed by surgical resection for non-small cell lung cancer (NSCLC) invading the thoracic inlet. Fischer, Stefan; Darling, Gail; Pierre, Andrew F.; Sun, Alexander; Leighl, Natasha; Waddell, Thomas K.; Keshavjee, Shaf; de Perrot, Marc // European Journal of Cardio-Thoracic Surgery;Jun2008, Vol. 33 Issue 6, p1129 

    Abstract: Objective: The role of induction therapy for non-small cell lung cancer (NSCLC) invading the thoracic inlet is unclear. We reviewed our experience with induction chemoradiation followed by surgical resection for NSCLC invading the thoracic inlet. Methods: We performed a retrospective...

  • How many pathological T1N0M0 non-small cell lung cancers can be completely resected in one segment? Special reference to high-resolution computed tomography findings. Horinouchi, Hirohisa; Nomori, Hiroaki; Nakayama, Takashi; Kohno, Mitsutomo; Izumi, Yotaro; Watanabe, Masazumi; Kawamura, Masafumi // Surgery Today;Aug2011, Vol. 41 Issue 8, p1062 

    Purpose: Although segmentectomy is attempted for small non-small cell lung cancer (NSCLC) tumors, no reports have so far described how many of these tumors can be candidates for a successful resection by single segmentectomy. Methods: In all, 135 patients with peripheral p-T1N0M0 NSCLC were...

  • Limited resection for clinical Stage IA non-small-cell lung cancers based on a standardized-uptake value index†. Shiono, Satoshi; Abiko, Masami; Sato, Toru // European Journal of Cardio-Thoracic Surgery;Jan2013, Vol. 43 Issue 1, pe7 

    OBJECTIVES In a previous study, we found that a standardized-uptake value (SUV) index obtained from positron emission tomography (PET)/computed tomography (CT) data was significantly correlated with prognosis in patients with pathological Stage I lung adenocarcinoma. However, this value has not...

  • The impact of the type of resection on survival in patients with N1 non-small-cell lung cancers Aydogmus, Umit; Cansever, Levent; Sonmezoglu, Yasar; Karapinar, Kemal; Kocaturk, Celalettin Ibrahim; Bedirhan, Mehmet Ali // European Journal of Cardio-Thoracic Surgery;Feb2010, Vol. 37 Issue 2, p446 

    Abstract: Objective: Complete resection is the therapy of choice in non-small-cell lung cancer (NSCLC). There is no agreement on the type of resection, especially when interlobar N1 disease is present. The present study explored the effect of the type of resection on survival in the presence of...

  • EGFR Mutations in Surgically Resected Fresh Specimens from 697 Consecutive Chinese Patients with Non-Small Cell Lung Cancer and Their Relationships with Clinical Features. Yuanyang Lai; Zhipei Zhang; Jianzhong Li; Dong Sun; Yong'an Zhou; Tao Jiang; Yong Han; Lijun Huang; Yifang Zhu; Xiaofei Li; Xiaolong Yan // International Journal of Molecular Sciences;Dec2013, Vol. 14 Issue 12, p24549 

    We aimed to reveal the true status of epidermal growth factor receptor (EGFR) mutations in Chinese patients with non-small cell lung cancer (NSCLC) after lung resections. EGFR mutations of surgically resected fresh tumor samples from 697 Chinese NSCLC patients were analyzed by Amplification...

  • Preoperative thrombocytosis is a significant unfavorable prognostic factor for patients with resectable non-small cell lung cancer. Miso Kim; Hyun Chang; Hee Chul Yang; Yu Jung Kim; Choon-Taek Lee; Jae-Ho Lee; Sanghoon Jheon; Kwhanmien Kim; Jin-Haeng Chung; Jong Seok Lee // World Journal of Surgical Oncology;2014, Vol. 12 Issue 1, p1 

    Background Previous studies have reported that pretreatment thrombocytosis is associated with poor outcomes in several cancer types. This study was designed to evaluate the prognostic significance of preoperative thrombocytosis in patients with non-small cell lung cancer (NSCLC) who undergo...

  • Lymphatic Vessel Density Is Not Associated With Lymph Node Metastasis in Non--Small Cell Lung Carcinoma. Faoro, Leonardo; Hutto, Joann Y.; Salgia, Ravi; El-Zayaty, Shady A.; Ferguson, Mark K.; Cheney, Richard T.; Reid, Mary E.; Armato III, Samuel G.; Krausz, Thomas; Husain, Aliya N. // Archives of Pathology & Laboratory Medicine;Dec2008, Vol. 132 Issue 12, p1882 

    Context.--Angiogenesis is essential for tumors to grow and metastasize. Lymphatic metastasis is also an important means of tumor spread. In non-small cell lung carcinoma, the relationship of lymphangiogenesis with lymph node metastasis and, ultimately, patient prognosis is unknown....

  • Completion pneumonectomy in cancer patients: experience with 55 cases Guggino, Gianluca; Doddoli, Christophe; Barlesi, Fabrice; Acri, Pablo; Chetaille, Bruno; Thomas, Pascal; Giudicelli, Roger; Fuentes, Pierre // European Journal of Cardio-Thoracic Surgery;Mar2004, Vol. 25 Issue 3, p449 

    Objective: Analysis of a single institution experience with completion pneumonectomy. Methods: From 1989 to 2002, 55 consecutive cancer patients received completion pneumonectomy (mean age 62 years; 25–79). Indications were bronchogenic carcinoma in 38 patients (4 first cancers, 8...

  • Initiation and Characterization of Small Cell Lung Cancer Patient-Derived Xenografts from Ultrasound-Guided Transbronchial Needle Aspirates. Anderson, Wade C.; Boyd, Michael B.; Aguilar, Jorge; Pickell, Brett; Laysang, Amy; Pysz, Marybeth A.; Bheddah, Sheila; Ramoth, Johanna; Slingerland, Brian C.; Dylla, Scott J.; Rubio, Edmundo R. // PLoS ONE;May2015, Vol. 10 Issue 5, p1 

    Small cell lung cancer (SCLC) is a devastating disease with limited treatment options. Due to its early metastatic nature and rapid growth, surgical resection is rare. Standard of care treatment regimens remain largely unchanged since the 1980’s, and five-year survival lingers near 5%....

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics