Anatomic Segmentectomy for Stage I Non-Small Cell Lung Cancer in the Elderly

Kilic, Arman; Schuchert, Matthew J.; Pettiford, Brian L.; Pennathur, Arjun; Landreneau, James R.; Landreneau, Joshua P.; Luketich, James D.; Landreneau, Rodney J.

doi:10.1016/j.athoracsur.2009.02.097

Cited by 138 publications

(89 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinically, according to the National Comprehensive Cancer Network (NCCN) guidelines, the standard treatment for early-stage NSCLC patients is curative-intent surgical lobectomy plus mediastinal lymph node dissection or systematic sampling (6). However, several previous publications have demonstrated that limited resection, including anatomic segmentectomy and nonanatomic wedge resection, will lead to equivalent survival outcomes compared with lobectomy, particularly among elderly patients (7)(8)(9)(10). Although the epidemic of lung cancer shows a trend of younger patients, there remains an urgent need to develop effective treatment methods for older patients.…”

Section: Introductionmentioning

confidence: 99%

“…However, lymph node sampling was not routinely performed. For patients who underwent lobectomy, we performed a complete lymph node dissection for accurate staging, which included stations 2, 4, 7, 8, 9, 10, 11, and 12 on the right and stations 5,6,7,8,9,10,11, and 12 on the left.To date, there remains a lack of standard criteria of surgical procedure selection for early-stage NSCLC patients. The factors that influence the surgical choice for elderly patients with stage I lung adenocarcinoma include tumor size, tumor density on CT, pulmonary function and so on (25).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

et al. 2018

View full text Add to dashboard Cite

Background: This study aimed to evaluate the prognostic difference between limited resection and lobectomy among elderly patients with small size lung adenocarcinoma. Methods: A total of 666 patients >65 years old with stage I lung adenocarcinoma and tumor size ≤2 cm were included. The patient survival was evaluated by disease-free survival (DFS) and overall survival (OS). Results: No DFS or OS advantage was found between the lobectomy and wedge resection groups when tumor sizes were ≤1 cm (DFS, P=0.112; OS, P=0.294). The wedge resection group had a significantly worse OS (P=0.041) than that in the lobectomy group when tumor sizes were >1 cm and ≤2 cm. Conclusions: We conclude that wedge resection may be a reasonable surgical choice for elderly patients with tumor sizes ≤1 cm. The International Association Study of Lung Cancer (IASLC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS) proposed a new edition of the lung adenocarcinoma classification system in 2011 (12). It has been effectively used to predict the prognosis of lung adenocarcinoma patients. The classification was established on the most predominant subtype presented: invasive adenocarcinoma with solid (SOL) or micropapillary (MIP) carcinoma, which is associated with a poor survival (13)(14)(15)(16)(17). Both adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) have nearly 100% postsurgical survival, and limited resection is appropriate for those patients. However, to date, whether limited resection is adequate for early-stage invasive lung adenocarcinoma patients, especially for patients who are older than 65, has not been thoroughly studied (8). In this study, a large cohort investigation was carried out to determine the correlation between surgical procedures and postoperative survival among elderly lung adenocarcinoma patients with tumor sizes ≤2 cm. Our study may help to design personalized surgical strategies for older patients. Methods Patient cohortThe retrospective study was permitted by the Institutional Review Board of Shanghai Chest Hospital at Shanghai Jiao Tong University and was performed in compliance with the guidelines of clinical research [ethic approval ID: KS(P)1802].We retrospectively reviewed patients who underwent surgical resection at our hospital between January 2009 and March 2015. The inclusion criteria were patients 65 years old or older, presentation of a single lung nodule, the postsurgical pathological specimen examination validated that the tumor size was less than or equal to 2 cm, there was no lymph node invasion, and there was no distant organ metastasis. The exclusion criteria included patients who had a history of malignancy, had multiple nodules, received neoadjuvant chemotherapy AIS or MIA. Invasive adenocarcinoma variants (such as mucinous, enteric or fetal morphologies) were also excluded for low incidence. Finally, this study included a total of 666 patients.In our clinical practice, patients with the following characteristics were treated with limited resect...

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

et al. 2018

View full text Add to dashboard Cite

show abstract

“…В данной группе больных с потенциально огра-ниченной продолжительностью жизни отмечено улуч-шение непосредственных результатов лечения без суще-ственного снижения отдаленных показателей [32,33].…”

Section: Discussionunclassified

Surgical treatment in patients with Stage I peripheral non-small cell lung cancer: Results, prognosis, prospects

Колбанов¹,

Trakhtenberg²,

Пикин³

et al. 2016

Onkol. Z. im. P.A. Gercena

View full text Add to dashboard Cite

Хирургическое лечение больных периферическим немелкоклеточным раком легкого I стадии: результаты, прогноз, перспективы К.И. Колбанов, а.Х. ТраХТенберг , о.в. ПИКИн, в.а. глушКо, в.а. багров Московский научно-исследовательский онкологический институт им. П.а. герцена -филиал Фгбу «национальный медицинский исследовательский радиологический центр» (дир. -чл.-корр. ран а.Д. Каприн) Минздрава россии, Москва, россия у функционально операбельных больных немелкоклеточным раком легкого (нМрл) методом выбора считают хирургиче-ское лечение, минимальный объем которого лобэктомия с медиастинальной лимфаденэктомией. Цель исследования -ретроспективная оценка результатов хирургического лечения больных периферическим нМрл Т1-2аN0M0 с учетом объема операции и ряда других клинико-морфологических факторов. Материал и методы. в анализ включены 363 паци-ента c периферическим нМрл до 4 см без метастазов в лимфатических узлах, которым выполнены лобэктомия (91,2%), сегментэктомия (3,6%) и неанатомическая резекция легкого (5,2%). Средний возраст больных составил 59,8 года, преоб-ладали мужчины (80,2%). опухоль относительно чаще локализовалась в правом легком (54,0%) и верхних долях (66,1%). у 188 пациентов диагностирована IA стадия (pT1а-bN0M0), у 175 -IB (рT2aN0M0). аденокарцинома выявлена у 47,4% больных, плоскоклеточный рак -у 39,2%, крупноклеточный -у 5,8%, аденоплоскоклеточный -у 6,0% и мукоэпидермо-идный -у 1,6%. Результаты. Послеоперационные осложнения диагностированы у 10,2% пациентов, летальность соста-вила 1,4%. общая 5-летняя выживаемость больных достигала 71%: при Т1a-b -76,1%, Т2а -67,1% (р>0,05). лучшие показатели наблюдались при плоскоклеточном раке (77,5%) и аденокарциноме (68,0%; р>0,05), более низкие -крупно-клеточном раке (50,4%; р=0,03). установлен неблагоприятный прогноз у больных после неанатомической резекция легко-го (43,8%; р<0,001) по сравнению с лобэктомией, выполненной из трансторакального доступа (72,4%) и сегментэктоми-ей (81,5%, р>0,05). Показатель общей 5-летней выживаемости после видеоторакоскопической лобэктомии сопоставим (77,6%) с таковым при торакотомных. При многофакторном анализе подтверждено негативное влияние на отдаленные результаты хирургического лечения морфологического типа нМрл и объема операции. Заключение. К неблагоприятным клинико-морфологическим факторам прогноза хирургического лечения больных нМрл (Т1-2аN0M0) следует относить крупноклеточный рак легкого и операцию в объеме неанатомической сублобарной резекции. Сегментэктомию как стан-дарт объема лечения можно рассматривать только у больных нМрл T1aN0M0. surgical treatment, the minimal volume of which is lobectomy with mediastinal lymphadenectomy, is considered the method of choice in functionally operable patients with non-small cell lung cancer (NsClC). Objective: to retrospectively assesse the results of surgical treatment in patients with peripheral NsClC (T1-2aN0M0) in view of the volume of surgery and a number of other clinical and morphological factors. Subjects and methods. The analysis included 363 patients with a peripheral NsCl...

show abstract

“…Two recent meta-analyses have failed to demonstrate a clear survival advantage of lobectomy over sublobar resections (30,40). Several retrospective analyses have shown no survival benefit for lobectomy over sublobar resections, especially segmentectomy, in stage IA lung cancer with a tumor diameter less than two cm (41)(42)(43)(44)(45)(46)(47)(48). There are also data that outcomes in sublobar resections are improved with margins at least equivalent to the size of the tumor and with adequate nodal assessment (1,43).…”

Section: Extent Of Surgery: Effectiveness Of Lobar and Sublobar Resecmentioning

confidence: 99%

Surgical treatment for early stage non-small cell lung cancer

et al. 2018

View full text Add to dashboard Cite

Anatomic Segmentectomy for Stage I Non-Small Cell Lung Cancer in the Elderly

Cited by 138 publications

References 22 publications

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

Surgical treatment in patients with Stage I peripheral non-small cell lung cancer: Results, prognosis, prospects

Surgical treatment for early stage non-small cell lung cancer

Contact Info

Product

Resources

About