Sublobar Resection With Brachytherapy Versus Lobectomy for Stage Ib Nonsmall Cell Lung Cancer

Birdas, Thomas J.; Koehler, Richard P.; Colonias, Athanasios; Trombetta, Mark; Maley, Richard H.; Landreneau, Rodney J.; Keenan, Robert J.

doi:10.1016/j.athoracsur.2005.08.052

Cited by 62 publications

(28 citation statements)

References 20 publications

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“…The 5-yr local control, locoregional control, and overall survival rates were 90%, 61%, and 18%, respectively. Another study from the same institution [51] comparing sublobar resection and brachytherapy (41 patients) with lobectomy (126 patients) for stage IB nonsmall cell lung cancer found no differences in local recurrence (4.8% for sublobar resections and 3.2% for lobectomies), disease-free survival (43.0% for sublobar resection and 42.8% for lobectomies), and overall survival (54.1% for sublobar resections and 51.8% for lobectomies). In the light of these results, the authors concluded that both treatments were equivalent and recommended the administration of brachytherapy whenever wedge resection had to be performed instead of lobectomy for stage IB tumours.…”

Section: Combined Therapiesmentioning

confidence: 98%

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: Combined Therapiesmentioning

confidence: 98%

Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2008

European Respiratory Journal

101

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“…The recent increase in MIS has also renewed an interest in the role of adjuvant brachytherapy for lung cancer [52][53][54][55][56][57][58][59]. Following resection of small lung tumours (T1N0), intraoperative I-125 seeds have been implanted with Vicryl ® mesh along the resection margins [52,53,57].…”

Section: Adjuvant Brachytherapy For Lung Cancermentioning

confidence: 99%

“…Intentional sublobar resection for small lung cancers (T1N0) has been performed using minimally invasive techniques with equivalent results [68][69][70][71][72][73][74]. Recently, intraoperative brachytherapy on the resection staple line has been shown to significantly decrease the local recurrence rates associated with these limited resections [52,54,55,57,59]. Our experience with intraoperative brachytherapy reveals this technique can achieve considerable lung volume sparing for irradiation to normal tissue with less than 2% lung volume receiving 20 Gy 1 (Fig.…”

Section: Adjuvant Brachytherapy For Lung Cancermentioning

confidence: 99%

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

Yu¹,

Lewis²,

Trejos³

et al. 2011

CRMR

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New technological concepts have been evolving to manage the relative poor prognosis of lung cancer. Brachytherapy is becoming an option for both unresectable and early resectable lung cancer. Three-dimensional ultrasound (US) of lung tumours and image-guided minimally invasive robotics-assisted brachytherapy are feasible for dosimetry planning and management of lung tumours. The present article reviews the current knowledge of lung brachytherapy and discusses its potential in future management of lung cancer.

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“…After a mean follow-up of 34.5 months, the brachytherapy decreased local recurrence rate significantly from 17.2% to 3.3% (p=0.012). Birdas et al (40) investigated 167 stage Ib NSCLC patients, comparing those 126 who underwent lobectomy with the 41 who had sublobar resection with iodine 125 brachytherapy over the resection staple line. They found that use of sublobar resection plus brachytherapy conferred similar rates of loco-regional recurrence, disease-free survival and overall survival as lobectomy -despite sublobar group patients having significantly worse preoperative pulmonary function.…”

Section: The Role Of Adjuvant Therapymentioning

confidence: 99%

Limited Resection for Lung Cancer: Current Role

Sihoe¹

2012

Toraks Cer Bult

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Sublobar resection for lung cancer-whether non-anatomic wedge resection or anatomic segmentectomy -has been performed for many decades. That it has never become a mainstream strategy for treating primary lung cancer is mainly due to evidence from the late 20 th Century demonstrating that it offers inferior results compared to conventional lobectomy in terms of survival and loco-regional recurrence rates. In recent years, however, emerging clinical evidence has begun to suggest otherwise. In selected patients with small tumors up to 2 cm diameter located in the periphery of the lung, it has been shown that survival after sublobar resection may approach that of postlobectomy. More importantly, the latest revisions to the adenocarcinoma classification system has further helped to identify candidates for sublobar resection -with tumors showing radiological features of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) being associated with potentially good outcomes after this type of surgery. The refinement of criteria to select patients that may benefit from sublobar resection has helped fuel the current resurgence of interest. Recent evidence has been less successful at demonstrating that sublobar resection delivers less morbidity than lobectomy. However, such comparison with lobectomy may not be the point. Current evidence simply does not support sublobar resection as a competitor to lobectomy as routine management for lung cancer. Instead, sublobar resection has been proven to be safe and feasible in patients who may not be candidates at all for lobectomy. In that sense, the role of sublobar resection may be to offer the hope of resectional therapy to selected patients who would otherwise have been denied surgery.

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Sublobar Resection With Brachytherapy Versus Lobectomy for Stage Ib Nonsmall Cell Lung Cancer

Cited by 62 publications

References 20 publications

Sublobar resection for lung cancer

Sublobar resection for lung cancer

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

Limited Resection for Lung Cancer: Current Role

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