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Ann Thorac Surg 1995;60:615-622
© 1995 The Society of Thoracic Surgeons
Abstract
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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A. Kraev, D. Rassias, J. Vetto, M. Torosoff, P. Ravichandran, C. Clement, A. Kadri, and R. Ilves Wedge Resection vs Lobectomy: 10-Year Survival in Stage I Primary Lung Cancer Chest, January 1, 2007; 131(1): 136 - 140. [Abstract] [Full Text] [PDF]
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P. C. Lee, R. J. Korst, J. L. Port, Y. Kerem, A. L. Kansler, and N. K. Altorki Long-term survival and recurrence in patients with resected non-small cell lung cancer 1 cm or less in size J. Thorac. Cardiovasc. Surg., December 1, 2006; 132(6): 1382 - 1388. [Abstract] [Full Text] [PDF]
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R. Timmerman, R. McGarry, C. Yiannoutsos, L. Papiez, K. Tudor, J. DeLuca, M. Ewing, R. Abdulrahman, C. DesRosiers, M. Williams, et al. Excessive Toxicity When Treating Central Tumors in a Phase II Study of Stereotactic Body Radiation Therapy for Medically Inoperable Early-Stage Lung Cancer J. Clin. Oncol., October 20, 2006; 24(30): 4833 - 4839. [Abstract] [Full Text] [PDF]
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M. Okada, T. Koike, M. Higashiyama, Y. Yamato, K. Kodama, and N. Tsubota Radical sublobar resection for small-sized non small cell lung cancer: A multicenter study J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 769 - 775. [Abstract] [Full Text] [PDF]
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A. Ketchedjian, B. D.T. Daly, H. C. Fernando, L. Florin, C. J. Hunter, D. M. Morelli, and R. J. Shemin Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 544 - 548. [Abstract] [Full Text] [PDF]
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T. Shiraishi, T. Shirakusa, M. Hiratsuka, S. Yamamoto, and A. Iwasaki Video-assisted thoracoscopic surgery lobectomy for c-T1N0M0 primary lung cancer: its impact on locoregional control. Ann. Thorac. Surg., September 1, 2006; 82(3): 1021 - 1026. [Abstract] [Full Text] [PDF]
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A. El-Sherif, W. E. Gooding, R. Santos, B. Pettiford, P. F. Ferson, H. C. Fernando, S. J. Urda, J. D. Luketich, and R. J. Landreneau Outcomes of Sublobar Resection Versus Lobectomy for Stage I Non-Small Cell Lung Cancer: A 13-Year Analysis Ann. Thorac. Surg., August 1, 2006; 82(2): 408 - 416. [Abstract] [Full Text] [PDF]
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T Treasure and M Utley Survival after resection for primary lung cancer. Thorax, August 1, 2006; 61(8): 649 - 650. [Full Text] [PDF]
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T-E Strand, H Rostad, B Moller, and J Norstein Survival after resection for primary lung cancer: a population based study of 3211 resected patients Thorax, August 1, 2006; 61(8): 710 - 715. [Abstract] [Full Text] [PDF]
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J-E C Holty and M K Gould When in doubt should we cut it out? The role of surgery in non-small cell lung cancer. Thorax, July 1, 2006; 61(7): 554 - 556. [Full Text] [PDF]
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G Wright, R L Manser, G Byrnes, D Hart, and D A Campbell Surgery for non-small cell lung cancer: systematic review and meta-analysis of randomised controlled trials Thorax, July 1, 2006; 61(7): 597 - 603. [Abstract] [Full Text] [PDF]
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G. J. Kelloff, S. M. Lippman, A. J. Dannenberg, C. C. Sigman, H. L. Pearce, B. J. Reid, E. Szabo, V. C. Jordan, M. R. Spitz, G. B. Mills, et al. Progress in Chemoprevention Drug Development: The Promise of Molecular Biomarkers for Prevention of Intraepithelial Neoplasia and Cancer--A Plan to Move Forward Clin. Cancer Res., June 15, 2006; 12(12): 3661 - 3697. [Abstract] [Full Text] [PDF]
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C. T. Bolliger, T. G. Sutedja, J. Strausz, and L. Freitag Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur. Respir. J., June 1, 2006; 27(6): 1258 - 1271. [Abstract] [Full Text] [PDF]
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 B. Mahesh, C. Forrester-Wood, K. Amer, and R. Ascione Value of Wedge Resection for Lung Cancer in Poor Cardiopulmonary Status Patients Asian Cardiovasc Thorac Ann, April 1, 2006; 14(2): 123 - 127. [Abstract] [Full Text] [PDF]
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 S. S. Shim, K. S. Lee, M. J. Chung, H. Kim, O J. Kwon, and S. Kim Do hemodynamic studies of stage t1 lung cancer enable the prediction of hilar or mediastinal nodal metastasis? Am. J. Roentgenol., April 1, 2006; 186(4): 981 - 988. [Abstract] [Full Text] [PDF]
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T. J. Birdas, R. P.M. Koehler, A. Colonias, M. Trombetta, R. H. Maley Jr, R. J. Landreneau, and R. J. Keenan Sublobar Resection With Brachytherapy Versus Lobectomy for Stage Ib Nonsmall Cell Lung Cancer Ann. Thorac. Surg., February 1, 2006; 81(2): 434 - 439. [Abstract] [Full Text] [PDF]
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T. Kawaguchi, A. Matsumura, K. Iuchi, S. Ishikawa, H. Maeda, S. Fukai, H. Komatsu, and M. Kawahara Second Primary Cancers in Patients with Stage III Non-Small Cell Lung Cancer Successfully Treated with Chemo-radiotherapy Jpn. J. Clin. Oncol., January 1, 2006; 36(1): 7 - 11. [Abstract] [Full Text] [PDF]
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 M. M. Oken, P. M. Marcus, P. Hu, T. M. Beck, W. Hocking, P. A. Kvale, J. Cordes, T. L. Riley, S. D. Winslow, S. Peace, et al. Baseline Chest Radiograph for Lung Cancer Detection in the Randomized Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial J Natl Cancer Inst, December 21, 2005; 97(24): 1832 - 1839. [Abstract] [Full Text] [PDF]
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H. Matsuoka, M. Okada, T. Sakamoto, and N. Tsubota Reply to Shanmugan et al. Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 913 - 913. [Full Text] [PDF]
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H. Harada, M. Okada, T. Sakamoto, H. Matsuoka, and N. Tsubota Functional Advantage After Radical Segmentectomy Versus Lobectomy for Lung Cancer Ann. Thorac. Surg., December 1, 2005; 80(6): 2041 - 2045. [Abstract] [Full Text] [PDF]
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G. Shanmugam, A. Jilaihawi, and D. Prakash Pulmonary resections in young octogenarians. Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 912 - 913. [Full Text] [PDF]
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C.S. Pramesh, R. C. Mistry, and J. Agarwal How Should Bronchioloalveolar Carcinoma of the Lung 3 Centimeters or Less Be Treated? Ann. Thorac. Surg., November 1, 2005; 80(5): 1978 - 1978. [Full Text] [PDF]
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H. Sakurai, Y. Dobashi, and M. Matsumoto Reply Ann. Thorac. Surg., November 1, 2005; 80(5): 1979 - 1979. [Full Text] [PDF]
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F. Barlesi, L. Boyer, C. Doddoli, S. Antoniotti, P. Thomas, and P. Auquier The Place of Patient Satisfaction in Quality Assessment of Lung Cancer Thoracic Surgery Chest, November 1, 2005; 128(5): 3475 - 3481. [Abstract] [Full Text] [PDF]
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C. L. Nguyen, W. J. Scott, N. A. Young, T. Rader, L. R. Giles, and M. Goldberg Radiofrequency Ablation of Primary Lung Cancer: Results From an Ablate and Resect Pilot Study Chest, November 1, 2005; 128(5): 3507 - 3511. [Abstract] [Full Text] [PDF]
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 C. J. Simon, D. E. Dupuy, and W. W. Mayo-Smith Microwave Ablation: Principles and Applications RadioGraphics, October 1, 2005; 25(suppl_1): S69 - S83. [Abstract] [Full Text] [PDF]
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S. Sawada, E. Komori, N. Nogami, A. Bessho, Y. Segawa, T. Shinkai, M. Nakata, and M. Yamashita Advanced Age Is Not Correlated With Either Short-term or Long-term Postoperative Results in Lung Cancer Patients In Good Clinical Condition Chest, September 1, 2005; 128(3): 1557 - 1563. [Abstract] [Full Text] [PDF]
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 S. G. Spiro and G. A. Silvestri One Hundred Years of Lung Cancer Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 523 - 529. [Abstract] [Full Text] [PDF]
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C. M. Mery, A. N. Pappas, R. Bueno, Y. L. Colson, P. Linden, D. J. Sugarbaker, and M. T. Jaklitsch Similar Long-term Survival of Elderly Patients With Non-small Cell Lung Cancer Treated With Lobectomy or Wedge Resection Within the Surveillance, Epidemiology, and End Results Database Chest, July 1, 2005; 128(1): 237 - 245. [Abstract] [Full Text] [PDF]
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