Intentional limited resection for selected patients with T1 N0 M0 non-small-cell lung cancer: A single-institution study

Kodama, Ken; Doi, Osamu; Higashiyama, Masahiko; Yokouchi, Hideoki

doi:10.1016/s0022-5223(97)70179-x

Cited by 313 publications

(210 citation statements)

References 7 publications

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“…A total of 14 studies (Hoffmann and Ransdell, 1980;Read et al, 1990;Date et al, 1994;Warren and Faber, 1994;Ginsberg and Rubinstein, 1995;Harpole et al, 1995;Lederle, 1996;Kodama et al, 1997;Landreneau et al 1997;Pastorino et al, 1997;Kwiatkowski et al, 1998;Okada et al, 2001;Koike et al, 2003;Campione et al, 2004;Keenan et al, 2004) served as data sources for the present meta-analysis (Table 2). Their designs were retrospective in 12, matched-pair in one, and RCT in one.…”

Section: Resultsmentioning

confidence: 99%

“…Although the randomised trial (Ginsberg and Rubinstein, 1995) concluded that limited resection should not be standard surgery even for small peripheral NSCLC, several surgeons (Kodama et al, 1997;Tsubota et al, 1998;Koike et al, 2003) have continued to perform some intentional limited resections. Indeed, results reported from various institutions up to now have been conflicting.…”

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confidence: 99%

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Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

et al. 2005

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Extent of resection needed to treat lung cancer has long been an issue. The sole randomised controlled trial, reported by the Lung Cancer Study Group, advised against limited resection as standard surgery even for small peripheral non-small-cell lung cancers (p3 cm), because of frequent local recurrences. Elsewhere, conflicting results have been reported from different institutions. We therefore conducted a meta-analysis of reported studies to compare survival of stage I patients between limited resection and standard lobectomy. A MEDLINE web search for computer-archived bibliographic data yielded 14 articles suitable for analysis. Combined survival differences (survival rate with lobectomy minus that with limited resection) at 1, 3, and 5 years after resection according to the DerSimonian -Laird random effects model were 0.7% (95% CI, À0.8 to 2.1; P ¼ 0.3659), 1.9% (95% CI, À3.7 to 7.4; P ¼ 0.5088), and 3.6% (95% CI, À0.4 to 10.5; P ¼ 0.3603), respectively. None of these survival differences were significant, indicating that survival after limited resection for stage I lung cancer was comparable to that after lobectomy. However, since interstudy heterogeneity was detected, caution is required in interpretation of the results.

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Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

et al. 2005

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“…SUBLOBAR RESECTIONS FOR SMALL SOLID AND PARTLY SOLID PERIPHERAL TUMOURS Indications Table 1 shows the most relevant data from 20 studies comparing lobectomy with sublobar resection [8,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. All but three were retrospective: one was a prospective but nonrandomised study [28] and two were prospective observational studies [20,34].…”

Section: Upper Lobementioning

confidence: 99%

Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2008

European Respiratory Journal

101

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Sublobar resection for small lung cancers has been debated frequently and is still a controversial issue. The only randomised trial comparing lobectomy with sublobar resections found a significantly higher recurrence rate for the latter, but failed to show significant differences in survival, although survival was better for the lobectomy group. One meta-analysis and several nonrandomised comparisons have confirmed these results. In general, lobectomy and sublobar resections have similar 5-yr survival rates. Local recurrence after wedge resection is higher than after segmentectomy. However, for patients aged .71 yrs, lobectomy and wedge resection are associated with similar survival. For tumours of f2 cm, segmentectomy is equivalent to lobectomy, but survival after segmentectomy is worse if performed for larger tumours. For both segmentectomy and wedge resection, tumour margins should be o1 cm wide to avoid recurrence. For pure bronchioloalveolar carcinoma of f2 cm, diagnosed intraoperatively with certainty, sublobar resection seems equivalent to lobectomy, and because there is no nodal involvement, systematic nodal dissection may not be necessary. In case of doubt, however, lobectomy with systematic nodal dissection will ensure complete resection and adequate staging. More randomised trials are needed to confirm all these issues.

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“…1,2) Recently, sublobar lung resection has been applied for early lung cancer to preserve the lung parenchyma. [3][4][5] The intraoperative diagnosis of LN metastasis is critical for this type of operation, though it is often missed in conventional frozen and permanent section examinations because it is difficult to detect areas of micrometastasis, even if sentinel LNs were recognized during the operation. 6,7) The one-step nucleic acid amplification (OSNA) assay is a novel technique that utilizes a loop-mediated isothermal amplification (RT-LAMP) method of gene amplification and usually requires approximately 30 minutes to obtain results.…”

Section: Introductionmentioning

confidence: 99%

One-step Nucleic Acid Amplification for Detection of Lymph Node Metastasis in Lung Cancer

Hayama

Chida

Karube

et al. 2014

ATCS

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Objective: Intraoperative diagnosis of lymph node (LN) metastasis is critical in lung cancer patients. The one-step nucleic acid amplification (OSNA) assay is a novel technique using a loop-mediated isothermal amplification method of gene amplification. The objective of this study was to investigate whether the OSNA assay provides sufficient diagnosis of LN metastasis in lung cancer patients. Methods: A total of 40 LN stations were dissected from the 20 patients, who had curative lobectomy for lung cancer. The cut halves of LNs were used for pathological diagnosis, and other halves were for the OSNA assay. The OSNA assay used cytokeratin (CK) 19 mRNA as a marker. The CK19 mRNA copy number was detected using RD-100i (Sysmex Corp., Hyogo, Japan). One formalin-fixed section with the largest cutting surface of the other halves of LNs was used for pathological examination. When discordance was observed between OSNA assay and usual pathological examination, an additional examination using 1-mm interval sections was performed. Results: In the forty LN stations, three stations were diagnosed as LN metastasis positive pathologically. In these three, the OSNA assays showed extremely high numbers of CK19 mRNA copies. When the cutoff value was set to 250 copies/µl, 4 stations with relatively low copy numbers were found to be discordant. Of the 4 discordant cases, one was shown to be micro-metastasis positive in the additional pathological assessment. The sensitivity of the OSNA assay was 100.0%, and its specificity was 91.7%. Conclusions: This method could be applied to intraoperative assessment LNs metastasis.

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Intentional limited resection for selected patients with T1 N0 M0 non-small-cell lung cancer: A single-institution study

Abstract: Segmentectomy with regional lymph node dissection, including the mediastinum, should be considered as an acceptable alternative treatment for selected patients with T1 N0 M0 disease.

Cited by 313 publications

References 7 publications

Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis

Sublobar resection for lung cancer

One-step Nucleic Acid Amplification for Detection of Lymph Node Metastasis in Lung Cancer

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