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Bertolaccini L, Casiraghi M, Uslenghi C, Diotti C, Mazzella A, Caffarena G, Spaggiari L. Advances in lung cancer surgery: the role of segmentectomy in early-stage management. Expert Rev Respir Med 2024; 18:669-675. [PMID: 38457174 DOI: 10.1080/17476348.2024.2324083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION The evolving landscape of surgical interventions for early-stage non-small cell lung cancer (NSCLC) necessitates a reassessment of the traditional gold standard of lobectomy versus emerging sublobar resections, prompting this critical narrative review. AREAS COVERED This review encompasses recent randomized controlled trials, notably JCOG0802/WJOG4607L and CALGB140503, comparing lobectomy and sublobar resections for early-stage NSCLC, focusing on tumor size and recurrence rates. It also discusses the importance of individualized decision-making, future research avenues, and technological advancements in lung cancer surgery. EXPERT OPINION In this rapidly evolving field, sublobar resections emerge as a viable alternative to lobectomy for tumors smaller than 2 cm in early-stage NSCLC, necessitating precise patient selection and ongoing technological advancements to optimize outcomes.
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Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Monica Casiraghi
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Clarissa Uslenghi
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Cristina Diotti
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Antonio Mazzella
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giovanni Caffarena
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Xiu J, Wang S, Wang X, Xu W, Hu Y, Hua Y, Xu S. Effectiveness and safety of segmentectomy vs. wedge resection for the treatment of patients with operable non‑small cell lung cancer: A meta‑analysis and systematic review. Oncol Lett 2024; 28:336. [PMID: 38846430 PMCID: PMC11153982 DOI: 10.3892/ol.2024.14469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/13/2024] [Indexed: 06/09/2024] Open
Abstract
The present study compared the differences in effectiveness and safety between segmentectomy (ST) and wedge resection (WR) in patients with operable non-small cell lung cancer (NSCLC). The PubMed, EMBASE, Cochrane Library and Web of Science databases were searched for papers published from inception until July 2023. The inclusion criteria were based on the population, intervention, comparator, outcomes and study designs. ROBINS-I was selected to assess the risk of bias and quality of evidence in the included non-randomised studies. Appropriate effect sizes were selected, and subgroup analyses, heterogeneity tests, sensitivity analyses and publication bias were applied. A total of 18 retrospective studies were included, involving 19,381 patients with operable NSCLC. The 5-year overall survival rate [hazard ratio (HR), 0.19; 95% confidence interval (CI), 0.04, 0.34; P=0.014; I2=76.3%], lung cancer-specific survival rate (HR, 0.3; 95% CI, 0.21, 0.38; P<0.01; I2=13.8%) and metastasis rate [odds ratio (OR), 1.56; 95% CI, 1.03, 2.38; P=0.037] in patients with operable NSCLC treated with WR were worse than those in patients treated with ST. The incidence of postoperative complications (OR, 0.44; 95% CI, 0.23, 0.82) in the WR group was lower than in the ST treatment group. There was no difference in postoperative recurrence (OR, 2.15; 95% CI, 0.97, 4.74; P=0.058) and mortality (risk difference, 0.04; 95% CI, -0.03, 0.11; P=0.287) between groups. Based on current evidence, patients with NSCLC treated with ST surgery have better postoperative survival but more complications than those patients treated with WT, while the effect of WR and ST on the recurrence rate and distant metastasis rate remains controversial.
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Affiliation(s)
- Jiawei Xiu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, P.R. China
- Graduate School, China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Shiqi Wang
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, P.R. China
| | - Xilong Wang
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, P.R. China
| | - Wei Xu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, P.R. China
| | - Yuhang Hu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, P.R. China
| | - Yujuan Hua
- Department of Anaesthesiology, General Hospital of Northern Theater, Shenyang, Liaoning 110016, P.R. China
| | - Shiguang Xu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, P.R. China
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Graur A, Saenger JA, Mercaldo ND, Simon J, Abston ED, Price MC, Lanciotti K, Swisher LA, Colson YL, Willers H, Lanuti M, Fintelmann FJ. Multimodality Management of Thoracic Tumors: Initial Experience With a Multidisciplinary Thoracic Ablation Conference. Ann Surg Oncol 2024; 31:3426-3436. [PMID: 38270827 DOI: 10.1245/s10434-024-14910-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND This study aimed to describe lesion-specific management of thoracic tumors referred for consideration of image-guided thermal ablation (IGTA) at a newly established multidisciplinary ablation conference. METHODS This retrospective single-center cohort study included consecutive patients with non-small cell lung cancer (NSCLC) or thoracic metastases evaluated from June 2020 to January 2022 in a multidisciplinary conference. Outcomes included the management recommendation, treatments received (IGTA, surgical resection, stereotactic body radiation therapy [SBRT], multimodality management), and number of tumors treated per patient. Pearson's chi-square test was used to assess for a change in management, and Poisson regression was used to compare the number of tumors by treatment received. RESULTS The study included 172 patients (58 % female; median age, 69 years; 56 % thoracic metastases; 27 % multifocal primary lung cancer; 59 % ECOG 0 [range, 0-3]) assessed in 206 evaluations. For the patients with NSCLC, IGTA was considered the most appropriate local therapy in 12 %, equal to SBRT in 22 %, and equal to lung resection in 3 % of evaluations. For the patients with thoracic metastases, IGTA was considered the most appropriate local therapy in 22 %, equal to SBRT in 12 %, and equal to lung resection in 3 % of evaluations. Although all patients were referred for consideration of IGTA, less than one third of patients with NSCLC or thoracic metastases underwent IGTA (p < 0.001). Multimodality management allowed for treatment of more tumors per patient than single-modality management (p < 0.01). CONCLUSIONS Multidisciplinary evaluation of patients with thoracic tumors referred for consideration of IGTA significantly changed patient management and facilitated lesion-specific multimodality management.
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Affiliation(s)
- Alexander Graur
- Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - Jonathan A Saenger
- Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA
- Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Zurich, Switzerland
| | | | - Judit Simon
- Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA
| | - Eric D Abston
- Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa C Price
- Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA
| | - Kori Lanciotti
- Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Lauren A Swisher
- Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Yolonda L Colson
- Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Henning Willers
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Lanuti
- Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Florian J Fintelmann
- Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA.
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Detterbeck F, Ely S, Udelsman B, Blasberg J, Boffa D, Dhanasopon A, Mase V, Woodard G. So Now We Know-Reflections on the Extent of Resection for Stage I Lung Cancer. Clin Lung Cancer 2024; 25:e113-e123. [PMID: 38310034 DOI: 10.1016/j.cllc.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/13/2023] [Indexed: 02/05/2024]
Abstract
Lobectomy has been the standard treatment for stage I lung cancer in healthy patients, largely based on a randomized trial published in 1995. Nevertheless, research has continued regarding the role of sublobar resection. Three additional randomized trials addressing resection extent in healthy patients have recently been published. These 4 trials involve differences in design, eligibility, interventions, and intraoperative processes. Patients were ineligible if intraoperative assessment demonstrated stage > IA or inadequate resection margins. All trials consistently show no differences in perioperative morbidity, mortality, and postoperative changes in lung function between sublobar resection and lobectomy-consistent with other nonrandomized evidence. Long-term outcomes are generally encouraging of lesser resection, but some inconsistencies are apparent. The 2 larger recent trials demonstrated no overall survival difference while the others suggested better survival after lobectomy versus sublobar resection. Recurrence-free survival was found to be the same after lobectomy versus sublobar resection in 3 trials, despite higher locoregional recurrences after sublobar resection. The low 5-year recurrence-free survival (64%, regardless of resection extent) in 1 recent trial highlights the need for further optimization. Thus, there is high-level evidence that sublobar resection is a reasonable alternative to lobectomy in healthy patients. However, variability in long-term results suggests that aspects of patients, tumors and interventions need to be better understood. Therefore, we propose to apply sublobar resection cautiously; especially because there are no short-term benefits. Sublobar resection requires careful attention to intraoperative details (nodes, margins), and may be best suited for less aggressive (eg, ground glass, slow growing) tumors.
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Affiliation(s)
- Frank Detterbeck
- Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT.
| | - Sora Ely
- Department of Surgery, George Washington University Medical School, Washington DC
| | - Brooks Udelsman
- Division of Thoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, CA
| | - Justin Blasberg
- Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Daniel Boffa
- Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Andrew Dhanasopon
- Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Vincnet Mase
- Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Gavitt Woodard
- Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
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Pischik VG, Kovalenko AI, Molkova AV, Yuryev EY, Zinchenko EI, Maslak OA. [Indocyanine green fluorescence in thoracoscopic segmentectomy: indications and benefits]. Khirurgiia (Mosk) 2024:13-23. [PMID: 38380460 DOI: 10.17116/hirurgia202402213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To determine the role of ICG fluorescence in segmentectomies. MATERIAL AND METHODS One surgical team performed 178 thoracoscopic anatomical segmentectomies in two hospitals between 2017 and 2023. Of these, 93 (52.2%) patients underwent ICG fluorescence perfusion tests. This study was retrospective and consecutive. Intraoperative and early postoperative results were analyzed. Patients were divided into 3 equal periods. Ventilation and perfusion methods were used to navigate the intersegmental planes in the first period. In the second one, only ventilation methods were used due to the absence of ICG. In the third period, the choice of navigation method was determined by «surgical complexity of segment». RESULTS In 74% of patients, surgeries were performed for primary or metastatic lung tumors. The scheduled procedure was performed in all patients. However, 2 ones required lobectomy for total resection. Uneventful postoperative period was observed in 69.7% of patients. Other ones had complications grade I-IIIA. No reoperations or mortality were recorded. CONCLUSION ICG perfusion is not inferior to ventilation methods in identification of intersegmental planes. This method is also more convenient for thoracoscopy. ICG fluorescence thoracoscopy is the only method in patients with COPD scheduled for thoracoscopic segmentectomy with two or more intersegmental planes.
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Affiliation(s)
- V G Pischik
- Saint Petersburg City Clinical Oncology Center, St. Petersburg, Russia
- Sokolov North-Western District Scientific Clinical Center, St. Petersburg, Russia
- Saint Petersburg State University, St. Petersburg, Russia
| | - A I Kovalenko
- Saint Petersburg City Clinical Oncology Center, St. Petersburg, Russia
- Sokolov North-Western District Scientific Clinical Center, St. Petersburg, Russia
| | - A V Molkova
- Saint Petersburg City Clinical Oncology Center, St. Petersburg, Russia
- Saint Petersburg State University, St. Petersburg, Russia
| | - E Yu Yuryev
- Saint Petersburg City Clinical Oncology Center, St. Petersburg, Russia
| | - E I Zinchenko
- Sokolov North-Western District Scientific Clinical Center, St. Petersburg, Russia
- Saint Petersburg State University, St. Petersburg, Russia
| | - O A Maslak
- Saint Petersburg State University, St. Petersburg, Russia
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Fong KY, Chan YH, Chia CML, Agasthian T, Lee P. Sublobar resection versus lobectomy for stage IA non-small-cell lung cancer ≤ 2 cm: a systematic review and patient-level meta-analysis. Updates Surg 2023; 75:2343-2354. [PMID: 37563486 DOI: 10.1007/s13304-023-01627-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023]
Abstract
Despite lobectomy being the standard of care for early-stage non-small-cell lung cancer (NSCLC), sublobar resection (segmentectomy or wedge resection) has recently been suggested to achieve similar outcomes. An electronic literature search was conducted to retrieve randomized controlled trials (RCTs) or propensity score-matched studies (PSMs) comparing lobectomy to sublobar resection in stage IA NSCLC ≤ 2 cm in size, with provision of Kaplan-Meier curves for overall survival (OS) and disease-free survival (DFS). A graphical reconstructive algorithm was used to obtain OS and DFS of individual patients, which was then pooled under random-effects individual patient data meta-analysis using Cox models to determine hazard ratios (HRs). Sensitivity analyses for OS and DFS were also performed, restricting to results from RCTs only. Seven studies (2528 patients) were retrieved. There were no significant differences in OS (shared-frailty HR = 0.92, 95% CI = 0.77-1.11, p = 0.378) or DFS (shared-frailty HR = 1.06, 95% CI = 0.90-1.24, p = 0.476) between lobectomy and sublobar resection. This comparison remained non-significant even when restricted to RCTs only. Pooled Kaplan-Meier curves of OS appeared to diverge over time, in favor of sublobar resection. This was confirmed on analysis of restricted mean survival time curves. This patient-level meta-analysis of high-quality studies demonstrates that sublobar resection is equivalent to lobectomy in patients with small stage IA NSCLC. Sublobar resection offers greater down-the-road benefits in patients who experience recurrence or a second primary tumor since the lung-sparing index surgery allows patients to receive further treatment safely. This heralds sublobar resection as the new standard of care in carefully selected early-stage patients.Trial registration: PROSPERO CRD42023385358.
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Affiliation(s)
- Khi Yung Fong
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cynthia Ming Li Chia
- Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore, Singapore
| | | | - Pyng Lee
- Department of Respiratory and Critical Care Medicine, National University Hospital, Singapore, Singapore
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Oudin V, Salleron J, Marchesi V, Peiffert D, Khadige M, Faivre JC. CyberKnife ® stereotactic radiation therapy for stage I lung cancer and pulmonary oligometastases: is fiducial implantation still relevant?-a cohort study. J Thorac Dis 2023; 15:4636-4647. [PMID: 37868838 PMCID: PMC10586995 DOI: 10.21037/jtd-22-1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 07/21/2023] [Indexed: 10/24/2023]
Abstract
Background Few studies have investigated whether there is a difference in local control or overall survival rates following treatment with robotic stereotactic body radiation therapy (SBRT) with or without prior fiducial marker implantation. Our study aimed to investigate this in patients with primary or secondary lung tumors. Methods A retrospective study was conducted at the Institut de Cancérologie de Lorraine of patients treated for primary lung cancer or pulmonary oligometastases with SBRT from January 2013 to July 2016. We included patients at least 18 years old who had stage I non-small cell lung cancer (NSCLC) or lung metastases and a follow-up of at least 1 month. Results A total of 294 patients were included. Tumors included 122 lung metastases, 89 stage I NSCLC, and 83 non-histologically confirmed lung lesions. The tracking methods were Synchrony® in 191 cases (119 gold seeds and 72 coils) and Xsight® Spine with 4D computed tomography in 103 cases. Median follow-up was 31.6 months [interquartile range (IQR), 18.1-50.2 months]. The two- and five-year probability of local control were respectively 92.22% [95% confidence interval (CI): 0.89-0.95] and 85.35% (95% CI: 0.79-0.99). The two- and five-year probability of overall survival were respectively 87.46% and 72.77% (P=0.586). Local control rates did not significantly differ between techniques at 2 and 5 years (P=0.685) (gold seeds, coils or Xsight® Spine) within tumors grouped by location, gross tumor volume (GTV) (respectively P=0.9, P=0.7, and P=0.4), planning target volume (PTV) (respectively P=0.4, P=0.9, and P=0.7), or PTV/GTV ratio (respectively P=0.6, P=0.6, and P=0.5). Metastasis-free survival and Overall survival rates did not significantly differ between techniques at 2 and 5 years (P=0.664 and P=0.586, respectively). There were no grade 4 or 5 toxicities and only one grade 3 pneumonitis and one grade 3 pneumothorax. Conclusions Fiducial-less SBRT using Xsight® Spine is a safe alternative to Synchrony® using gold seeds or coils, with comparable local control and overall survival rates and a similar toxicity profile.
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Affiliation(s)
- Victor Oudin
- Department of Radiation Oncology, Georges François Leclerc Hospital, Dijon, France
- Department of Radiation Oncology, Lorraine Cancer Institute-Alexis-Vautrin, Vandœuvre-lès-Nancy, France
| | - Julia Salleron
- Department of Data Management and Biostatistics, Lorraine Cancer Institute-Alexis-Vautrin, Vandœuvre-lès-Nancy, France
| | - Vincent Marchesi
- Department of Radiation Oncology, Georges François Leclerc Hospital, Dijon, France
| | - Didier Peiffert
- Department of Radiation Oncology, Georges François Leclerc Hospital, Dijon, France
- EA 4360 APEMAC, University of Lorraine, Nancy, France
| | - Myriam Khadige
- Department of Radiation Oncology, Georges François Leclerc Hospital, Dijon, France
- Gray Institute, Maubeuge, France
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Butts E, Gococo-Benore D, Pai T, Moustafa MA, Heng F, Chen R, Zhao Y, Manochakian R, Lou Y. Brief report: risk stratification following curative therapy for stage I NSCLC. Front Oncol 2023; 13:1250315. [PMID: 37645428 PMCID: PMC10461311 DOI: 10.3389/fonc.2023.1250315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Surveillance with computed tomography (CT) imaging following curative treatment of stage I non-small cell lung cancer (NSCLC) is important to identify recurrence or second primary lung cancers (SPLC). The pattern and risks of recurrence following curative therapy and optimal duration of surveillance scans remain unknown. The objective of our study is to assess the pattern of recurrence and development of SPLC to risk stratify patients with stage I NSCLC following curative therapy. Methods We identified 261 patients who received curative therapy for stage I NSCLC at Mayo Clinic Florida. Data was collected on clinical and demographic features including gender, smoking history, stage, treatment, histologic subtype, and tumor grade. Kaplan-Meier method was used to evaluate the disease free survival (DFS). Cox proportional hazard model was used to identify risk factors for recurrence. Results Negative tobacco history and stage IA tumors were associated with significantly prolonged DFS after adjusting for co-variates (p=0.001 and p=0.005). Univariate Cox proportional hazards model identified tobacco history and stage 1B as risk factors for recurrence with unadjusted hazard ratio (HR) of 2.8 and 2.0, respectively. After adjusting for covariates, only stage IB was statistically significant predictor of recurrence with a hazard ratio of 2.1 (Confidence Interval (CI) 95% 1.2-3.6; p=0.007). Conclusions An individualized approach that considers risk factors of stage and smoking history may be useful in determining whether to continue annual CT surveillance after five years post curative therapy for stage I NSCLC.
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Affiliation(s)
- Emily Butts
- Department of Internal Medicine, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Denise Gococo-Benore
- Department of Internal Medicine, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Tanmayi Pai
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Muhamad Alhaj Moustafa
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Fei Heng
- Department of Mathematics and Statistics, University of North Florida, Jacksonville, FL, United States
| | - Ruqin Chen
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Yujie Zhao
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Rami Manochakian
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, United States
| | - Yanyan Lou
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, United States
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Behinaein P, Treffalls J, Hutchings H, Okereke IC. The Role of Sublobar Resection for the Surgical Treatment of Non-Small Cell Lung Cancer. Curr Oncol 2023; 30:7019-7030. [PMID: 37504369 PMCID: PMC10378348 DOI: 10.3390/curroncol30070509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
Lung cancer is the most common cancer killer in the world. The standard of care for surgical treatment of non-small cell lung cancer has been lobectomy. Recent studies have identified that sublobar resection has non-inferior survival rates compared to lobectomy, however. Sublobar resection may increase the number of patients who can tolerate surgery and reduce postoperative pulmonary decline. Sublobar resection appears to have equivalent results to surgery in patients with small, peripheral tumors and no lymph node disease. As the utilization of segmentectomy increases, there may be some centers that perform this operation more than other centers. Care must be taken to ensure that all patients have access to this modality. Future investigations should focus on examining the outcomes from segmentectomy as it is applied more widely. When employed on a broad scale, morbidity and survival rates should be monitored. As segmentectomy is performed more frequently, patients may experience improved postoperative quality of life while maintaining the same oncologic benefit.
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Affiliation(s)
- Parnia Behinaein
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - John Treffalls
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Hollis Hutchings
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
| | - Ikenna C Okereke
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
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