Margin and Local Recurrence After Sublobar Resection of Non-Small Cell Lung Cancer

El-Sherif, Amgad; Fernando, Hiran C.; Santos, Ricardo; Pettiford, Brian L.; Luketich, James D.; Close, John M.; Landreneau, Rodney J.

doi:10.1245/s10434-007-9421-9

Cited by 216 publications

(145 citation statements)

References 17 publications

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“…Wedge resections had, therefore, narrower resection margins and were associated with higher local recurrence. In the series of EL-SHERIF et al [43], resection margins had no impact on regional or distant recurrence. In the study of SIENEL et al [44], 56 patients underwent segmentectomy with systematic nodal dissection and 31 underwent wedge resection with selective nodal sampling at the surgeon's discretion for stage I nonsmall cell lung cancer.…”

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 81%

“…Two reports present retrospective comparisons of segmentectomy and wedge resection [43,44]. The report by EL-SHERIF et al [43] focuses on the relationship between resection margin and local recurrence in patients with stage I nonsmall cell lung cancer who underwent either segmentectomy or wedge resection.…”

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

“…The report by EL-SHERIF et al [43] focuses on the relationship between resection margin and local recurrence in patients with stage I nonsmall cell lung cancer who underwent either segmentectomy or wedge resection. In the group of patients who underwent segmentectomy, there were more resections with resection margins .1 cm.…”

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

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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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Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 81%

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

See 1 more Smart Citation

Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2008

European Respiratory Journal

101

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“…The mortality rate was very low; however, the longtime survival rate was inferior to reports before 2000, which were investigations based on non-biased patient populations, [10][11][12][13] while the rate of local recurrence did not change. [13,14] In addition, the 5-YSR was not different between the wedge/sublobar resection and lobectomy groups.…”

Section: [6]mentioning

confidence: 83%

Pulmonary wedge resection for clinical stage I non-small cell lung cancer: a review of a mini-invasive treatment

Sawabata¹,

Kawase²,

Takahashi³

et al. 2017

MIS

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Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related deaths in the world. Therefore, there is a need to intensify treatments of these tumors. Because stage I NSCLC is a nonmetastatic disease, local therapies are indicated, among which surgery is the most commonly deployed strategy. Pulmonary wedge/sublobar resection is therefore discussed in comparison to stereotactic body radiation therapy for stage I lung cancer. Review of retrospective and prospective clinical trials reveal similar outcomes for both strategies, while a multicenter randomized prospective study comparing the efficacy of both therapies is on-going. Because the results of pulmonary wedge/sublobar resection may depend on tumor size, tumor-distance from surgical margin, tumor size-to-margin distance ratio, and margin cytology, prospective studies to evaluate the clinical implications of these factors, so as to inform patient prognostication, are recommended. Key words:Non-small cell lung cancer, wedge resection, sublobar resection, stage I, stereotactic body radiation therapy ABSTRACTArticle history:

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“…Recent evidence suggests that segmentectomy (inclusive of systematic hilar and mediastinal lymph node dissection) could be considered as a valid alternative to lobectomy in patients with tumours ,2 cm and limited pulmonary function [59,60]. Some have suggested that the ratio between surgical margin and tumour diameter should be kept .1 in order to minimise the risk of local relapse [61]. Recently, a large retrospective study (SEER) showed that lobectomy and segmentectomy resulted in similar survival among patients with small (,1 cm) tumours [62].…”

Section: Surgery For Early Stage Lung Cancer (Stage I and Ii)mentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Margin and Local Recurrence After Sublobar Resection of Non-Small Cell Lung Cancer

Abstract: Margin is an important consideration after SR of NSCLC. Wedge resection is frequently associated with margins less than 1 cm and a high risk for locoregional recurrence. Segmentectomy appears to be a better choice of SR when this is chosen as therapy.

Cited by 216 publications

References 17 publications

Sublobar resection for lung cancer

Sublobar resection for lung cancer

Pulmonary wedge resection for clinical stage I non-small cell lung cancer: a review of a mini-invasive treatment

Surgery for nonsmall cell lung cancer

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