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Ann Thorac Surg 1995;60:615-623
© 1995 The Society of Thoracic Surgeons


Articles

Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer

Lung Cancer Study Group, Robert J. Ginsberg, MD*, Lawrence V. Rubinstein, PhD

Accepted for publication April 1, 1995.

* Address reprint requests to Dr Ginsberg, Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021.

Background.: It has been reported that limited resection (segment or wedge) is equivalent to lobectomy in the management of early stage (T1–2 N0) non-small cell lung cancer.

Methods.: A prospective, multiinstitutional randomized trial was instituted comparing limited resection with lobectomy for patients with peripheral T1 N0 non-small cell lung cancer documented at operation. Analysis included locoregional and distant recurrence rates, 5-year survival rates, perioperative morbidity and mortality, and late pulmonary function assessment.

Results.: There were 276 patients randomized, with 247 patients eligible for analysis. There were no significant differences for all stratification variables, selected prognostic factors, perioperative morbidity, mortality, or late pulmonary function. In patients undergoing limited resection, there was an observed 75% increase in recurrence rates (p = 0.02, one-sided) attributable to an observed tripling of the local recurrence rate (p = 0.008 two-sided), an observed 30% increase in overall death rate (p = 0.08, one-sided), and an observed 50% increase in death with cancer rate (p = 0.09, one-sided) compared to patients undergoing lobectomy (p = 0.10, one-sided was the predefined threshold for statistical significance for this equivalency study).

Conclusions.: Compared with lobectomy, limited pulmonary resection does not confer improved perioperative morbidity, mortality, or late postoperative pulmonary function. Because of the higher death rate and locoregional recurrence rate associated with limited resection, lobectomy still must be considered the surgical procedure of choice for patients with peripheral T1 N0 non-small cell lung cancer.




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J. Thorac. Cardiovasc. Surg.Home page
H. Nomori, Y. Ohba, H. Shibata, K. Shiraishi, T. Mori, and S. Shiraishi
Required area of lymph node sampling during segmentectomy for clinical stage IA non-small cell lung cancer
J. Thorac. Cardiovasc. Surg., January 1, 2010; 139(1): 38 - 42.
[Abstract] [Full Text] [PDF]


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ChestHome page
P. G. Barnett, L. Ananth, M. K. Gould, and for the Veterans Affairs Positron Emission Tomogra
Cost and Outcomes of Patients With Solitary Pulmonary Nodules Managed With PET Scans
Chest, January 1, 2010; 137(1): 53 - 59.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
Q. Zhou, K. Suzuki, Y.-i. Anami, S. Oh, and K. Takamochi
Clinicopathologic features in resected subcentimeter lung cancer - status of lymph node metastases
Interact CardioVasc Thorac Surg, January 1, 2010; 10(1): 53 - 57.
[Abstract] [Full Text] [PDF]


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RadiologyHome page
M. D. Beland, E. J. Wasser, W. W. Mayo-Smith, and D. E. Dupuy
Primary Non-Small Cell Lung Cancer: Review of Frequency, Location, and Time of Recurrence after Radiofrequency Ablation
Radiology, January 1, 2010; 254(1): 301 - 307.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
M. J. Schuchert, B. L. Pettiford, A. Pennathur, G. Abbas, O. Awais, J. Close, A. Kilic, R. Jack, J. R. Landreneau, J. P. Landreneau, et al.
Anatomic segmentectomy for stage I non-small-cell lung cancer: Comparison of video-assisted thoracic surgery versus open approach.
J. Thorac. Cardiovasc. Surg., December 1, 2009; 138(6): 1318 - 1325.e1.
[Abstract] [Full Text] [PDF]


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RadiologyHome page
M. C. B. Godoy and D. P. Naidich
Subsolid Pulmonary Nodules and the Spectrum of Peripheral Adenocarcinomas of the Lung: Recommended Interim Guidelines for Assessment and Management
Radiology, December 1, 2009; 253(3): 606 - 622.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. Pennathur, J. D. Luketich, D. E. Heron, M. J. Schuchert, S. Burton, G. Abbas, W. E. Gooding, P. F. Ferson, C. Ozhasoglu, S. Gilbert, et al.
Stereotactic Radiosurgery for the Treatment of Lung Neoplasm: Experience in 100 Consecutive Patients
Ann. Thorac. Surg., November 1, 2009; 88(5): 1594 - 1600.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. Pennathur, G. Abbas, W. E. Gooding, M. J. Schuchert, S. Gilbert, N. A. Christie, R. J. Landreneau, and J. D. Luketich
Image-Guided Radiofrequency Ablation of Lung Neoplasm in 100 Consecutive Patients by a Thoracic Surgical Service
Ann. Thorac. Surg., November 1, 2009; 88(5): 1601 - 1608.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
J-J. Hung, W-J. Jeng, J-S. Liu, and W-H. Hsu
Differential diagnosis and management of focal pulmonary ground-glass opacities
Eur. Respir. J., October 1, 2009; 34(4): 1008 - 1009.
[Full Text] [PDF]


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Eur Respir JHome page
M. Infante
From the authors:
Eur. Respir. J., October 1, 2009; 34(4): 1009 - 1010.
[Full Text] [PDF]


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Ann. Thorac. Surg.Home page
M. F. Berry, J. Hanna, B. C. Tong, W. R. Burfeind Jr, D. H. Harpole, T. A. D'Amico, and M. W. Onaitis
Risk Factors for Morbidity After Lobectomy for Lung Cancer in Elderly Patients
Ann. Thorac. Surg., October 1, 2009; 88(4): 1093 - 1099.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
T. Koike, K.-i. Togashi, T. Shirato, S. Sato, H. Hirahara, M. Sugawara, F. Oguma, H. Usuda, and I. Emura
Limited Resection for Noninvasive Bronchioloalveolar Carcinoma Diagnosed by Intraoperative Pathologic Examination
Ann. Thorac. Surg., October 1, 2009; 88(4): 1106 - 1111.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
M. Okada
Invited Commentary
Ann. Thorac. Surg., October 1, 2009; 88(4): 1111 - 1111.
[Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
S. Yamada, A. Suga, Y. Inoue, and H. Inoue
Use of multi-detector row angiography for the arrangement of video-assisted modified segmental resection
Eur J Cardiothorac Surg, October 1, 2009; 36(4): 727 - 730.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
H. Igai, M. Takahashi, K. Ohata, A. Yamashina, T. Matsuoka, K. Kameyama, T. Nakagawa, and N. Okumura
Surgical treatment for non-small cell lung cancer in octogenarians - the usefulness of video-assisted thoracic surgery
Interact CardioVasc Thorac Surg, August 1, 2009; 9(2): 274 - 277.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
H. Oizumi, N. Kanauchi, H. Kato, M. Endoh, S.-i. Takeda, J. Suzuki, K. Fukaya, and M. Sadahiro
Total thoracoscopic pulmonary segmentectomy
Eur J Cardiothorac Surg, August 1, 2009; 36(2): 374 - 377.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
A. Brunelli, A. Charloux, C. T. Bolliger, G. Rocco, J-P. Sculier, G. Varela, M. Licker, M. K. Ferguson, C. Faivre-Finn, R. M. Huber, et al.
ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)
Eur. Respir. J., July 1, 2009; 34(1): 17 - 41.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
R. Maeda, N. Isowa, H. Onuma, H. Miura, T. Harada, H. Touge, H. Tokuyasu, and Y. Kawasaki
The maximum standardized uptake values on positron emission tomography to predict the Noguchi classification and invasiveness in clinical stage IA adenocarcinoma measuring 2 cm or less in size
Interact CardioVasc Thorac Surg, July 1, 2009; 9(1): 70 - 73.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
R. Maeda, N. Isowa, H. Onuma, H. Miura, T. Harada, H. Touge, H. Tokuyasu, and Y. Kawasaki
The maximum standardized 18F-fluorodeoxyglucose uptake on positron emission tomography predicts lymph node metastasis and invasiveness in clinical stage IA non-small cell lung cancer
Interact CardioVasc Thorac Surg, July 1, 2009; 9(1): 79 - 82.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. Kilic, M. J. Schuchert, B. L. Pettiford, A. Pennathur, J. R. Landreneau, J. P. Landreneau, J. D. Luketich, and R. J. Landreneau
Anatomic Segmentectomy for Stage I Non-Small Cell Lung Cancer in the Elderly
Ann. Thorac. Surg., June 1, 2009; 87(6): 1662 - 1668.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
M. Shapiro, T. S. Weiser, J. P. Wisnivesky, C. Chin, M. Arustamyan, and S. J. Swanson
Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer.
J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1388 - 1393.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
P. M. B. van Tilburg, H. Stam, H. C. Hoogsteden, and R. J. van Klaveren
Pre-operative pulmonary evaluation of lung cancer patients: a review of the literature
Eur. Respir. J., May 1, 2009; 33(5): 1206 - 1215.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
K. Kameyama, M. Takahashi, K. Ohata, H. Igai, A. Yamashina, T. Matsuoka, T. Nakagawa, and N. Okumura
Evaluation of the new TNM staging system proposed by the International Association for the Study of Lung Cancer at a single institution.
J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1180 - 1184.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
K. Yoshimoto, H. Nomori, T. Mori, H. Kobayashi, Y. Ohba, H. Shibata, K. Tashiro, S. Shiraishi, and T. Kobayashi
Quantification of the impact of segmentectomy on pulmonary function by perfusion single-photon-emission computed tomography and multidetector computed tomography.
J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1200 - 1205.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
A. Watanabe, S. Ohori, S. Nakashima, T. Mawatari, N. Inoue, Y. Kurimoto, and T. Higami
Feasibility of video-assisted thoracoscopic surgery segmentectomy for selected peripheral lung carcinomas
Eur J Cardiothorac Surg, May 1, 2009; 35(5): 775 - 780.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
A. Pennathur, J. D. Luketich, D. E. Heron, G. Abbas, S. Burton, M. Chen, W. E. Gooding, C. Ozhasoglu, R. J. Landreneau, and N. A. Christie
Stereotactic radiosurgery for the treatment of stage I non-small cell lung cancer in high-risk patients.
J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 597 - 604.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
T. Chamogeorgakis, C. Ieromonachos, E. Georgiannakis, and D. Mallios
Does lobectomy achieve better survival and recurrence rates than limited pulmonary resection for T1N0M0 non-small cell lung cancer patients?
Interact CardioVasc Thorac Surg, March 1, 2009; 8(3): 364 - 372.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
R. Rami-Porta and M. Tsuboi
Sublobar resection for lung cancer
Eur. Respir. J., February 1, 2009; 33(2): 426 - 435.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
E. Jakobsen, T. Palshof, K. Osterlind, and H. Pilegaard
Data from a national lung cancer registry contributes to improve outcome and quality of surgery: Danish results
Eur J Cardiothorac Surg, February 1, 2009; 35(2): 348 - 352.
[Abstract] [Full Text] [PDF]




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