Segmental resection spares pulmonary function in patients with stage I lung cancer

Keenan, Robert J.; Landreneau, Rodney J.; Maley, Richard H.; Singh, Deepak; Macherey, Robin S.; Bartley, Susan; Santucci, Tibetha

doi:10.1016/j.athoracsur.2004.01.024

Cited by 371 publications

(265 citation statements)

References 18 publications

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“…However, sublobar resection is another surgical option, whose features include a low complication rate, short hospitalization duration, and a high preservation of lung function (23,24). In recent studies, sublobar resection has shown equivalent oncological results and survival outcome compared with lobectomy (25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Tsai¹,

Lin²,

Hsu³

et al. 2017

J. Vis. Surg.

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Section: Discussionmentioning

confidence: 99%

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Tsai¹,

Lin²,

Hsu³

et al. 2017

J. Vis. Surg.

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“…Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm import role in the surgical strategy for elderly patients for the advantage of preserving pulmonary function and vital lung parenchyma (11).…”

Section: Original Articlementioning

confidence: 99%

“…However, lymph node sampling was not routinely performed. For patients who underwent lobectomy, we performed a complete lymph node dissection for accurate staging, which included stations 2, 4, 7, 8, 9, 10, 11, and 12 on the right and stations 5,6,7,8,9,10,11, and 12 on the left.To date, there remains a lack of standard criteria of surgical procedure selection for early-stage NSCLC patients. The factors that influence the surgical choice for elderly patients with stage I lung adenocarcinoma include tumor size, tumor density on CT, pulmonary function and so on (25).…”

mentioning

confidence: 99%

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

et al. 2018

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Background: This study aimed to evaluate the prognostic difference between limited resection and lobectomy among elderly patients with small size lung adenocarcinoma. Methods: A total of 666 patients >65 years old with stage I lung adenocarcinoma and tumor size ≤2 cm were included. The patient survival was evaluated by disease-free survival (DFS) and overall survival (OS). Results: No DFS or OS advantage was found between the lobectomy and wedge resection groups when tumor sizes were ≤1 cm (DFS, P=0.112; OS, P=0.294). The wedge resection group had a significantly worse OS (P=0.041) than that in the lobectomy group when tumor sizes were >1 cm and ≤2 cm. Conclusions: We conclude that wedge resection may be a reasonable surgical choice for elderly patients with tumor sizes ≤1 cm. The International Association Study of Lung Cancer (IASLC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS) proposed a new edition of the lung adenocarcinoma classification system in 2011 (12). It has been effectively used to predict the prognosis of lung adenocarcinoma patients. The classification was established on the most predominant subtype presented: invasive adenocarcinoma with solid (SOL) or micropapillary (MIP) carcinoma, which is associated with a poor survival (13)(14)(15)(16)(17). Both adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) have nearly 100% postsurgical survival, and limited resection is appropriate for those patients. However, to date, whether limited resection is adequate for early-stage invasive lung adenocarcinoma patients, especially for patients who are older than 65, has not been thoroughly studied (8). In this study, a large cohort investigation was carried out to determine the correlation between surgical procedures and postoperative survival among elderly lung adenocarcinoma patients with tumor sizes ≤2 cm. Our study may help to design personalized surgical strategies for older patients. Methods Patient cohortThe retrospective study was permitted by the Institutional Review Board of Shanghai Chest Hospital at Shanghai Jiao Tong University and was performed in compliance with the guidelines of clinical research [ethic approval ID: KS(P)1802].We retrospectively reviewed patients who underwent surgical resection at our hospital between January 2009 and March 2015. The inclusion criteria were patients 65 years old or older, presentation of a single lung nodule, the postsurgical pathological specimen examination validated that the tumor size was less than or equal to 2 cm, there was no lymph node invasion, and there was no distant organ metastasis. The exclusion criteria included patients who had a history of malignancy, had multiple nodules, received neoadjuvant chemotherapy AIS or MIA. Invasive adenocarcinoma variants (such as mucinous, enteric or fetal morphologies) were also excluded for low incidence. Finally, this study included a total of 666 patients.In our clinical practice, patients with the following characteristics were treated with limited resect...

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“…4,6) Several studies showed segmentectomy offered significantly better functional preservation compared with lobectomy. 7,8) In the present cases, complete resection was able to achieve by consecutive segmentectomy, on behalf of performing lobectomy of two lobes. In case 2, the patient was able to undergo the left lung wedge resection following right side surgery in consequence of the well preserved pulmonary function.…”

Section: Discussionmentioning

confidence: 92%

Multiple Segmentectomy for Synchronous Multiple Small Peripheral Lung Cancers: Report of Two Cases

Ohtsuka¹,

Okui²,

Nakayama³

et al. 2012

ATCS

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Treatment strategies for synchronous, multiple peripheral lung cancers remain controversial. Bilobectomy for multiple lung cancers could cause pulmonary function impairment. We report two patients with synchronous multiple peripheral non-small cell lung cancers, who underwent multiple segmentectomy simultaneously. This is the first report of consecutive segmentectomy of two segments.Keywords: lung cancer, segmentectomy, pulmonary function derwent two segmentectomy simultaneously. Case 1A 63-year-old man was referred to our institution for an abnormal shadow on chest CT. Chest CT showed a 1.5 cm nodule in the right S1(apical segment) and a 1.9 cm nodule in the right S8 (anterior basal segment) (Fig. 1A and 1B). CT guided needle biopsy of the right S1 nodule showed adenocarcinoma. A pulmonary function test showed a vital capacity (VC) of 4760 ml and forced expiratory volume in one second (FEV 1.0 ) of 3180 ml. Segmentectomy of right S1, segmentectomy of right S8, and lymph node dissection was performed. The sentinel lymph nodes were identified and examined by intraoperative frozen sections as previously reported.5) The final pathological examination revealed mixed type adenocarcinoma with p-T1aN0M0 stage IA for both S1 and S8. Expansion of the residual lung in the right lung was reasonable. No postoperative complications were observed. The patient was discharged on the 7th postoperative day. His postoperative pulmonary function test in 3 months after the operation showed a VC of 3990 ml and FEV 1.0 of 2750 ml.

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Segmental resection spares pulmonary function in patients with stage I lung cancer

Cited by 371 publications

References 18 publications

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

Multiple Segmentectomy for Synchronous Multiple Small Peripheral Lung Cancers: Report of Two Cases

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