Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer

Landreneau, Rodney J.; Sugarbaker, David J.; Mack, Michael J.; Hazelrigg, Stephen R.; Luketich, James D.; Fetterman, Lynda S.; Liptay, Michael J.; Bartley, Susan; Boley, Theresa M.; Keenan, Robert J.; Ferson, Peter F.; Weyant, Robert J.; Naunheim, Keith S.

doi:10.1016/s0022-5223(97)70226-5

Cited by 354 publications

(167 citation statements)

References 23 publications

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“…Previous studies reported an association between sublobar resection and locoregional recurrence, [43][44][45][46] which suggests worse lung cancer-specific mortality. Lower pulmonary function test and higher comorbidity status seen in the sublobar resection group indicate selection bias on the basis of cardiorespiratory condition and explains the worse noncancerspecific outcomes (Data Supplement).…”

Section: Discussionmentioning

confidence: 99%

Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non–Small-Cell Lung Cancer: A Competing Risks Analysis

Eguchi

Bains

Lee³

et al. 2017

JCO

170

127

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To perform competing risks analysis and determine short-and long-term cancer-and noncancerspecific mortality and morbidity in patients who had undergone resection for stage I non-small-cell lung cancer (NSCLC). Patients and MethodsOf 5,371 consecutive patients who had undergone curative-intent resection of primary lung cancer at our institution (2000 to 2011), 2,186 with pathologic stage I NSCLC were included in the analysis. All preoperative clinical variables known to affect outcomes were included in the analysis, specifically, Charlson comorbidity index, predicted postoperative (ppo) diffusing capacity of the lung for carbon monoxide, and ppo forced expiratory volume in 1 second. Cause-specific mortality analysis was performed with competing risks analysis. ResultsOf 2,186 patients, 1,532 (70.1%) were $ 65 years of age, including 638 (29.2%) $ 75 years of age. In patients , 65, 65 to 74, and $ 75 years of age, 5-year lung cancer-specific cumulative incidence of death (CID) was 7.5%, 10.7%, and 13.2%, respectively (overall, 10.4%); noncancer-specific CID was 1.8%, 4.9%, and 9.0%, respectively (overall, 5.3%). In patients $ 65 years of age, for up to 2.5 years after resection, noncancer-specific CID was higher than lung cancer-specific CID; the higher noncancer-specific, early-phase mortality was enhanced in patients $ 75 years of age than in those 65 to 74 years of age. Multivariable analysis showed that low ppo diffusing capacity of lung for carbon monoxide was an independent predictor of severe morbidity (P , .001), 1-year mortality (P , .001), and noncancer-specific mortality (P , .001), whereas low ppo forced expiratory volume in 1 second was an independent predictor of lung cancer-specific mortality (P = .002). ConclusionIn patients who undergo curative-intent resection of stage I NSCLC, noncancer-specific mortality is a significant competing event, with an increasing impact as patient age increases.

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Section: Discussionmentioning

confidence: 99%

Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non–Small-Cell Lung Cancer: A Competing Risks Analysis

Eguchi

Bains

Lee³

et al. 2017

JCO

170

127

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show abstract

“…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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“…In the 1997 study of the efficacy of thoracoscopic surgery for stage I NSCLC, Landreneau et al [9] reported a 5-YSR of 58%, 65%, and 70% for patients who received open wedge resection, video-assisted wedge resection, and lobectomy, respectively. Although the calculated survival rate was not statistically significant between the open and video-assisted wedge resection groups, there was a difference in the 5-YSR between the wedge resection and lobectomy groups due to a significantly greater non-cancer-related deaths that occurred within 5 years among the wedge resection group (38% vs. 18%, P = 0.014).…”

Section: [6]mentioning

confidence: 99%

Pulmonary wedge resection for clinical stage I non-small cell lung cancer: a review of a mini-invasive treatment

Sawabata¹,

Kawase²,

Takahashi³

et al. 2017

MIS

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Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related deaths in the world. Therefore, there is a need to intensify treatments of these tumors. Because stage I NSCLC is a nonmetastatic disease, local therapies are indicated, among which surgery is the most commonly deployed strategy. Pulmonary wedge/sublobar resection is therefore discussed in comparison to stereotactic body radiation therapy for stage I lung cancer. Review of retrospective and prospective clinical trials reveal similar outcomes for both strategies, while a multicenter randomized prospective study comparing the efficacy of both therapies is on-going. Because the results of pulmonary wedge/sublobar resection may depend on tumor size, tumor-distance from surgical margin, tumor size-to-margin distance ratio, and margin cytology, prospective studies to evaluate the clinical implications of these factors, so as to inform patient prognostication, are recommended. Key words:Non-small cell lung cancer, wedge resection, sublobar resection, stage I, stereotactic body radiation therapy ABSTRACTArticle history:

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Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer

Cited by 354 publications

References 23 publications

Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non–Small-Cell Lung Cancer: A Competing Risks Analysis

Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non–Small-Cell Lung Cancer: A Competing Risks Analysis

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Pulmonary wedge resection for clinical stage I non-small cell lung cancer: a review of a mini-invasive treatment

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