Sublobar resection without staging and lymphadenectomy for ≤2 cm Non-Small Cell Lung Cancer is no adequate therapy

Schlachtenberger, Georg; Doerr, Fabian; Menghesha, Hruy; Hagmeyer, Lars; Bennink, Gerardus; Gaisendrees, Christopher; Wahlers, Thorsten; Hekmat, Khosro; Heldwein, M.

doi:10.1016/j.suronc.2022.101840

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Many articles have compared the clinical performances of lobar vs. sublobar surgery in early-stage lung cancer, and recent data suggest that the second approach is superior in small-sized lung cancer (<2.0 cm in diameter with a relevant ground glass component) [ 4 , 5 , 24 , 25 , 26 ]. Although these results have created great interest among oncologists and surgeons and are going to change clinical practice, some details still need to be clarified.…”

Section: Discussionmentioning

confidence: 99%

Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Piloni

Bertuccio

Primiceri

et al. 2023

JCM

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Background. Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. Patients and Methods. Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. Results. The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient’s gender. Conclusions. Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer.

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Section: Discussionmentioning

confidence: 99%

Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Piloni

Bertuccio

Primiceri

et al. 2023

JCM

View full text Add to dashboard Cite

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“…Schlachtenberger et al reported that 16.5% of patients with NSCLC ≤2 cm had lymph node upstage after surgery. It was emphasized that lymph node dissection and proper staging are important for resected NSCLC patients, regardless of tumor size or surgical approach ( 26 ).…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of lymph node dissection for lung cancer surgery: a narrative review

Ichiki¹,

Taguchi²,

Yanagihara³

et al. 2023

J Thorac Dis

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Background and Objectives: Theoretically, systematic lymph node dissection (SLND) in lung cancer surgery is a technique that leaves less cancer cells behind and is speculated to improve the prognosis, but its prognostic significance still remains controversial. In addition, the social environment surrounding lymph node dissection has changed with the advent of limited surgery for peripheral small-sized lung cancer and emergence of immune check inhibitor (ICI). Therefore, we reconsidered the role of lymph node dissection.Methods: By referring to past reports, we reviewed the process leading up to the establishment of SLND in lung cancer surgery. We compared five randomized prospective comparative studies on SLND and lymph node sampling (LNS) in lung cancer surgery.

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Sublobar resection without staging and lymphadenectomy for ≤2 cm Non-Small Cell Lung Cancer is no adequate therapy

Cited by 2 publications

References 29 publications

Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Prognostic significance of lymph node dissection for lung cancer surgery: a narrative review

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