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Ann Thorac Surg 2004;77:1902-1903
© 2004 The Society of Thoracic Surgeons

Invited commentary

Thomas A. D'Amico, MD

Duke University Medical Center Box 3496 Durham, NC 27710, USA

e-mail: damic001@mc.duke.edu

The first 20% of the full text of this article appears below.

Lobectomy has become the standard surgical management for patients with stage I non-small cell lung cancer (NSCLC), based on a report from the Lung Cancer Study Group that demonstrated improved recurrence-free survival, when compared to patients that underwent limited resection [1]. However, there may be patients with compromised pulmonary function in whom the relative benefit of lobectomy versus limited resection is outweighed by the relative risk. Patients in whom the risk-benefit analysis may be particularly important include patients with a higher risk from surgery, such as patients with restrictive lung disease [2], or patients with small peripheral nodules, in whom the relative benefits of lobectomy may not be as significant [3]. The process of preoperative risk stratification, therefore, is central to the choice of procedure [4].

Iizasa and colleagues analyze the prognostic value of preoperative pulmonary function in a series of patients who are treated with lobectomy for stage I non-small cell lung cancer [5]. The potential for this type of risk analysis is considerable: as screening with spiral CT becomes . . . [Full Text of this Article]




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T. Iizasa and T. Fujisawa
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Ann. Thorac. Surg., June 1, 2005; 79(6): 2198 - 2198.
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