THE VALUE OF LIMITED RESECTION FOR CLINICAL STAGE-I PERIPHERAL NONSMALL CELL LUNG-CANCER IN POOR-RISK PATIENTS - COMPARISON OF LIMITED RESECTION AND LOBECTOMY BY A COMPUTER-ASSISTED MATCHED STUDY

Aim: A computer-assisted retrospective matched study was devised to compare limited resection and lobectomy for nonsmall cell lung cancer. Methods: Of 353 patients undergoing operation for ''clinical'' stage I peripheral non-small cell lung cancer, 16 patients undergoing limited resection (because of poor risk) could be matched satisfactorily with 16 patients undergoing lobectomy (as a standard procedure) on the basis of age, sex, histology, tumor location, and tumor size with computer assistance. Results: No hospital death was observed in the 32 patients. Three of the 16 limited resection patients (19%) developed local recurrence in the same lobe. The 5-year survival rate was 55.5% for limited resection and 73.7% for lobectomy (P = not significant). For tumors more than 2.0 cm in diameter, 3-year survival rate was significantly lower in the limited resection group than in the lobectomy group: 34.3% versus 85.7%, P < 0.05. For adenocarcinoma, limited resection seemed to be more unfavorable than lobectomy: 5-year survival rate, 34.3% versus 75.0%, P = 0.07. Conclusions: Limited resection offered a good survival rate without hospital death for poor-risk patients; however, lobectomy should be performed for good-risk patients.