Pulmonary function after segmentectomy for small peripheral carcinoma of the lung

Takizawa, T; Haga, Manabu; Yagi, Nobuo; Terashima, Masanori; Uehara, Hiroko; Yokoyama, Akira; Kurita, Yuichi

doi:10.1016/s0022-5223(99)70193-5

Cited by 66 publications

(58 citation statements)

References 19 publications

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“…Many studies reported preserved pulmonary function after limited resection, compared with lobectomy (8,22,23). In our study, postoperative/preoperative FVC and FEV 1 ratios were significantly higher in the limited resection group than in the lobectomy group.…”

Section: Discussionsupporting

confidence: 50%

Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer

Koike

Sato

et al. 2016

J. Thorac. Dis.

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Background: Although lobectomy is the standard surgical procedure for non-small cell lung cancer (NSCLC), recent studies show favorable outcomes after limited resection in patients with small-sized peripheral tumors. We conducted a randomized controlled trial of such patients to estimate postoperative outcomes and pulmonary function following these surgical techniques.Methods: Between 2005 and 2008, eligible patients with tumors of 2 cm or less were randomly assigned 1:1 to undergo lobectomy or limited resection; 32 and 33 NSCLC patients in each group, respectively, were analyzed. The primary end points were 5-year overall survival (OS) and disease-free survival (DFS), while the secondary end points were postoperative pulmonary function including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1 ). Results:The 5-year OS rates were 93.8% and 90.9% in the lobectomy and limited resection groups, respectively (P=0.921). The 5-year DFS rates were 93.8% and 90.9% in the lobectomy and limited resection groups, respectively (P=0.714). These rates did not differ significantly between the two resection groups.The median postoperative/preoperative FVC ratios were 84.1% and 90.0% in the lobectomy and limited resection groups, respectively, while the median postoperative/preoperative FEV 1 ratios were 81.9% and 89.1%, respectively. Both ratios were significantly higher in the limited resection group (P=0.032 and P=0.005 for FVC and FEV 1 ratios, respectively). Conclusions:A similar outcome, with more preserved postoperative pulmonary function, was observed in patients who underwent limited resection compared to those who underwent lobectomy. Ongoing largescale multi-institutional prospective randomized trials of lobar versus sublobar resection in patients with small peripheral NSCLCs will hopefully provide definitive information about intentional limited resection of small peripheral tumors.

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Section: Discussionsupporting

confidence: 50%

Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer

Koike

Sato

et al. 2016

J. Thorac. Dis.

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“…TAKIZAWA et al [45] studied post-operative lung function in 40 patients who had undergone segmentectomy but who could otherwise have undergone lobectomy, and in 40 matched patients who had undergone lobectomy. Pre-operative forced vital capacity (FVC) and preoperative FEV1 were similar.…”

Section: Post-operative Pulmonary Functionmentioning

confidence: 99%

“…These two studies [45,46] were performed in patients with good pre-operative pulmonary function. In patients with lung disease, careful evaluation of the type, degree and location of the lung abnormalities is important in order to select the best lung resection.…”

Section: Post-operative Pulmonary Functionmentioning

confidence: 99%

Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2008

European Respiratory Journal

100

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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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“…Compared with those who undergo traditional lobectomy, patients who undergo anatomic segmentectomy have less lung tissue resected and more lung function preserved, contributing to a subsequent higher quality of life (2)(3)(4). There are reportedly no significant differences…”

Section: Introductionmentioning

confidence: 99%

Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study

Lin¹,

Zheng²,

Guo³

et al. 2016

J. Thorac. Dis.

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Background: There are few reports of single-port video-assisted thoracoscopic surgery (S-VATS) anatomic segmentectomy and S-VATS lobectomy for early-stage non-small cell lung cancer (NSCLC) and no comparisons between them have yet been reported. Therefore, the aim of this study was to compare the safety and efficacy of S-VATS anatomic segmentectomy and S-VATS lobectomy for early-stage NSCLC.Methods: In this retrospective observational study, the outcomes of 79 consecutive patients who had undergone S-VATS anatomic segmentectomy (32 patients) or S-VATS lobectomy (47 patients) for earlystage NSCLC from April 2014 to June 2015 were examined. The operation time, intraoperative blood loss, numbers of dissected lymph nodes and mediastinal nodal stations, numbers of staples used, postoperative drainage volume and duration, duration of hospital stay, costs, postoperative complications, local recurrence, and survival were compared between these two groups.Results: The postoperative drainage volume was smaller and the postoperative drainage duration shorter in the S-VATS segmentectomy than the lobectomy group (P<0.05). There were no significant differences in operation time, intraoperative blood loss, number of staples used, number and stations of dissected mediastinal lymph nodes, duration of hospital stay, costs, or postoperative complications. At the time of writing, no deaths or local recurrences had occurred in either group.Conclusions: S-VATS segmentectomy is as safe and effective as S-VATS lobectomy. Patients who undergo S-VATS segmentectomy seem to recover faster. in local tumor recurrence rate and total 5-year survival rate between these two surgical options (5-7). Anatomic segmentectomy is clearly the less invasive. The Non-small Cell Lung Cancer Clinical Practice Guidelines issued by the National Comprehensive Cancer Network in 2010 recommend anatomic segmentectomy as a suitable operative procedure for treating early-stage non-small cell lung cancer (NSCLC) (8). The size and number of operative incisions can be used as an index of the severity of operative wounds (9,10). In accordance with the above data, surgeons have gradually begun to attempt single-port video-assisted thoracoscopic surgery (S-VATS), which is less invasive than previously performed procedures. Although Gonzalez et al. have reported outcomes of S-VATS lobectomy (11) and anatomic segmentectomy (12) and Zhu et al. have reported the comparison of the feasibility and safety between singleport and triple-port complete thoracoscopic lobectomy for NSCLC (13), there are few reports comparing S-VATS anatomic segmentectomy and lobectomy for early stage NSCLC.In this study we retrospectively analyzed data on 32 patients who had undergone S-VATS anatomic segmentectomy and 47 patients who had undergone S-VATS lobectomy for early stage NSCLC in our institution and explored the safety, efficacy, advantages, and disadvantages of these two operative procedures. MethodsIn this study, data for 79 patients who had undergone S-VATS procedures [32 anatomic segment...

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Pulmonary function after segmentectomy for small peripheral carcinoma of the lung

Cited by 66 publications

References 19 publications

Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer

Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer

Sublobar resection for lung cancer

Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study

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