Sublobar resection is equivalent to lobectomy for clinical stage 1A lung cancer in solid nodules

Altorki, Nasser K.; Yip, Rowena; Hanaoka, Takaomi; Bauer, Thomas; Aye, Ralph W.; Kohman, Leslie J.; Sheppard, Barry; Thurer, Richard J.; Andaz, Shahriyour; Smith, Michael V.; Mayfield, William; Grannis, Fred; Korst, Robert J.; Pass, Harvey I.; Straznicka, Michaela; Flores, Raja M.; Henschke, Claudia I.

doi:10.1016/j.jtcvs.2013.09.065

Cited by 295 publications

(247 citation statements)

References 33 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). Moreover, in 2010, Sugi and colleagues reported a retrospective study of 159 patients, revealing that there were no significant differences among the wedge resection, segmentectomy, and lobectomy approaches in the treatment of small NSCLC (28).…”

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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“…The only case who had a one-stage bilateral lobectomy in our series suffered complications necessitating artificial ventilation for 4 days. Sublobar resection has been shown to be equivalent to lobectomy for clinical stage-IA solitary lung cancers (19). However, Zuin and colleagues (18) showed that patients who had a lobectomy showed better 5-year survival than those who underwent sublobar resection (57.5% and 36%, respectively, P=0.016).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the classification of lesions employed was not known given the different prognoses of various subtypes of lesions (4). For patients with small-sized and well-differentiated lesions, such as pGGO <2 cm and AIS/MIA, 5-year survival might not necessarily be compromised by sublobar resections (segmentectomy and wedge resection) (19,20). Thus, a one-stage bilateral procedure might be suitable.…”

Section: Discussionmentioning

confidence: 99%

Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules

Yao¹,

Yang²,

Zhao³

2016

J. Thorac. Dis.

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Background: Surgical treatment is thought to be the most effective strategy for multiple small nodules.However, in general, one-stage bilateral resection is not recommended due to its highly invasive nature.Methods: Clinical records of patients undergoing one-stage bilateral resections of multiple pulmonary nodules between January 2009 and September 2014 in a single institution were retrospectively reviewed.Results: Simultaneous bilateral pulmonary resection by conventional video-assisted thoracic surgery (VATS) was undertaken in 29 patients. Ground glass opacity (GGO) accounted for 71.9% (46/64) of total lesions, including 26 pure GGO and 20 mixed GGO lesions. One case underwent bilateral lobectomy that was complicated by postoperative dyspnea. Lobar-sublobar (L/SL) resection and bilateral sublobar resection (SL-SL) were conducted in 16 and 12 cases, respectively, and most of these cases had uneventful postoperative courses.There was no significant difference with regard to postoperative complications (P=0.703), duration of use of chest drains (P=0.485), between one-and two-stage groups. Mean postoperative follow-up in cases of primary lung cancer was 31.4 (range, 10-51) months. There was neither recurrence nor deaths at final follow-up. Conclusions Materials and methods PatientsThe study was approved by the ethics committee of Shanghai Chest Hospital. During the period of Jan 1 2009 to Sep 30 2014, cases performed with various pulmonary resections at our department were retrospectively reviewed. Twenty nine cases underwent single-stage bilateral operations of multiple pulmonary nodules were identified. For comparison, 89 patients with bilateral multiple nodules who underwent two-stage operations at the same period were also reviewed. Clinical and histologic features and surgical outcomes were studied. Surgical procedureGeneral anesthesia with double-lumen endotracheal intubation was administered.Single-stage bilateral surgical treatment by video-assisted thoracic surgery (VATS) was applied based on the following rules: patients with good performance status, patient's informed consent, characteristics of multiple pulmonary foci and individual surgeon's experience. The choice of surgical types comprehensively depends on the site of tumors, the evaluation of cardiopulmonary function reserve and outcomes of intraoperative frozen sections. Single-stage resection was performed with starting on the side of the less invasive resection, such as segmentectomy and wedge resection, generally depending on the size and morphology on preoperative chest computed tomography (CT). For planed bilateral sublobar resections, the priority was given to the right side.The patient was placed in the lateral decubitus position. After a one-sided procedure, the patient was rotated to the opposite side for a second resection. Cushions were used to lift the patient to avoid kicking or compression to the contralateral chest tube during positioning. Multiple primary lung cancer was diagnosed based on Martini-Melamed criteria (3).The comp...

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“…Several single centre retrospective studies have been published with conflicting conclusions (21,22 (24). CT imaging was used to determine the invasive potential of the tumour on the basis of the ratio of consolidation (C) to the maximal tumour diameter (T) (C/T ratio).…”

Section: Conservative Interventions: Sublobar Resection (Slr) and Bromentioning

confidence: 99%

Management of stage I and II nonsmall cell lung cancer

et al. 2016

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Sublobar resection is equivalent to lobectomy for clinical stage 1A lung cancer in solid nodules

Abstract: Sublobar resection and lobectomy have equivalent survival for patients with clinical stage IA non-small cell lung cancer in the context of computed tomography screening for lung cancer.

Cited by 295 publications

References 33 publications

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules

Management of stage I and II nonsmall cell lung cancer

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