Sublobar Resection for Early-Stage Lung Cancer

被引:38
作者
Schuchert, Matthew J. [1 ]
Abbas, Ghulam [1 ]
Pennathur, Arjun [1 ]
Nason, Katie S. [1 ]
Wilson, David O. [2 ]
Luketich, James D. [1 ]
Landreneau, Rodney J. [1 ]
机构
[1] UPMC Hlth Syst, Heart Lung & Esophageal Surg Inst, Div Thorac & Foregut Surg, Shadyside Med Bldg Suite 715,5200 Ctr Ave, Pittsburgh, PA 15232 USA
[2] UPMC Hlth Syst, Dept Med, Div Pulm Med, Pittsburgh, PA USA
关键词
sublobar; segmentectomy; wedge resection; lobectomy; non-small cell lung cancer; brachytherapy; VATS;
D O I
10.1053/j.semtcvs.2010.04.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The use of sublobar resection techniques (anatomic segmentectomy; extended wedge) in the treatment of early-stage non-small cell lung cancer has been associated with increased local recurrence rates compared with lobectomy. Recent data, however, have suggested that sublobar resection of smaller tumors (especially those ≤2 cm) can be performed with no significant difference in local recurrence or long-term survival. These findings have particular relevance in elderly patients and in those patients who may be at high risk for lobectomy because of underlying medical comorbidities. Careful patient selection on the basis of individualized assessment of specific patient and tumor characteristics will aid in selecting the optimal approach. For larger tumors, or when adequate surgical margins are not obtainable, lobectomy should be performed. Currently, active, prospective, randomized studies (Cancer and Leukemia Group B [CALGB] 140503 and American College of Surgeons Oncology Group [ACOSOG] Z4032) will provide critical insights in delineating the efficacy of sublobar resection techniques in early-stage non-small cell lung cancer. © 2010 Elsevier Inc.
引用
收藏
页码:22 / 31
页数:10
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