Is survival after sublobar resection vs. lobectomy made equivalent by extent of lymphadenectomy?

Song, Kimberly J.; Flores, Raja M.

doi:10.21037/atm.2019.07.33

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…This is due to the better oncological radicality obtainable with pulmonary lobectomy. In fact, during sublobar resections in not easy to sample the interlobar lymph nodes (station 11) whose cancer invasion can explain recurrences (46,47). Currently, has found consensus among the Authors the hypothesis about bronchial airspace involvement by locally spread of malignant cell elements (48)(49)(50).…”

Section: Discussionmentioning

confidence: 99%

Lobectomy versus sublobar resection in patients with non-small cell lung cancer: a systematic review

Divisi¹,

Vico²,

Zaccagna³

et al. 2020

J Thorac Dis

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Surgery is the gold standard treatment of lung cancer. The minimally invasive technique does not only concern access to the chest but also the limits of parenchymal resection. The study debates on the safety and oncological adequacy of sublobar resections in bronchogenic carcinoma patients. A systematic analysis of the data in the literature was carried out, comparing the outcomes of patients with resectable non-small lung cancer (NSCLC) who underwent lobectomy or sublobar resection. These last interventions include both segmentectomies and wedge resections taking into consideration the following parameters: complications, relapse rate and overall survival. The complication rate is higher in patients underwent lobectomy compared to sublobar resection, especially in presence of high comorbidity index or octogenarian patients (overall values respectively between 0 and 48% and 0 and 46.6%). Contrarily, the relapse rate (6.2% to 32% vs.3.6% to 53.4%) and overall survival (50.2% to 93.8% vs. 38.6% to 100%) are more favorable in patients undergoing lobectomy. Sublobar resections are particularly indicated in elderly patients and in patients with high comorbidity index or reduced respiratory functional reserve. However, pulmonary lobectomy still remains the safest and oncologically correct method in patients with good performance status or higher risk of recurrence.

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Section: Discussionmentioning

confidence: 99%

Lobectomy versus sublobar resection in patients with non-small cell lung cancer: a systematic review

Divisi¹,

Vico²,

Zaccagna³

et al. 2020

J Thorac Dis

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Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59�patients

et al. 2020

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A standard treatment for patients with early-stage non-small cell lung cancer (NSCLC) who undergo surgery, and subsequently develop local failure or intrathoracic oligorecurrence, has not yet been established. The present study aimed to assess the feasibility of stereotactic body radiotherapy (SBRT) for this subgroup of patients. Consequently, a retrospective analysis was conducted of patients with NSCLC recurrence who were treated with SBRT, and previously underwent curative surgical resection between October 2011 and October 2016. Post-SBRT survival [overall survival (OS); progression-free survival (PFS); and local control (LC)] and toxicity were analyzed. Prognostic factors for OS were identified using univariate and multivariate analysis. A total of 52 patients and 59 tumors were analyzed. The median follow-up time was 25 months (35 months for surviving patients), and median OS following salvage SBRT was 32 months. The 1-and 3-year OS rates were 84.4 and 67.8%, respectively. 1-and 3-year PFS rates were 80.8 and 58.7%, respectively. Only 4 patients (7.7%) developed local failure. Median LC was 71 months and 1-and 3-year LC rate were 97.9 and 94.9%, respectively. A total of 4 patients experienced grade 3 or higher adverse events (AEs) and two experienced grade 5 AEs (pneumonitis and hemoptysis). Central tumor location and the possibility of re-operation were independent prognostic factors for OS. The present study indicated that post-operative salvage SBRT is a promising therapeutic option for patients with NSCLC with locoregional or intrathoracic oligo-recurrence. We regard toxicity was also acceptable. However, further research is required on the appropriate selection of subjects, and stratification of the analysis by certain risk factors would increase the accuracy of the conclusions.

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Is survival after sublobar resection vs. lobectomy made equivalent by extent of lymphadenectomy?

Cited by 2 publications

References 9 publications

Lobectomy versus sublobar resection in patients with non-small cell lung cancer: a systematic review

Lobectomy versus sublobar resection in patients with non-small cell lung cancer: a systematic review

Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59�patients

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