POINT: Should Segmentectomy Rather Than Lobectomy Be the Operation of Choice for Early-Stage Non-small Cell Lung Cancer? Yes

D’Andrilli, Antonio; Rendina, Erino Angelo

doi:10.1016/j.chest.2017.10.038

Cited by 10 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, tumor size was also associated with a higher risk of decreased OS and CSS upon multivariate analysis. Nowadays, lobectomy has been recommended as the standard surgical procedure for operable NSCLC (3,24), especially for tumors larger than 2 cm (25)(26)(27). Based on our data, lobectomy should be considered as the first choice for NSCLC > 5 to 7 cm which was congruent with the current guidelines.…”

Section: Discussionsupporting

confidence: 77%

Choice of Treatment for Patients With Non–small-cell Lung Cancer >5 cm Between Surgery Alone and Surgery Plus Adjuvant Radiotherapy

et al. 2021

View full text Add to dashboard Cite

Background: According to the lung cancer staging project, T2b (>5–7 cm) and T3 (>7 cm) non-small cell lung cancers (NSCLC) should be reclassified into T3 and T4 groups. The objective of this study was to evaluate the effect of surgery alone or surgery plus adjuvant radiation (SART) on survival of node-negative patients with NSCLC >5 cm.Methods: We identified 4557 N0 patients with NSCLC >5 cm in the Surveillance, Epidemiology, and End Results database from 2004 to 2014. Overall survival (OS) and cancer–specific survival (CSS) were compared among patients who underwent surgery alone and SART. The proportional hazards model was applied to evaluate multiple prognostic factors.Results: 1,042 and 525 patients who underwent surgery alone and SART, respectively were enrolled after propensity-score matching. OS and CSS favored surgery alone rather than SART. Multivariate analysis showed that the number of lymph nodes examined more than six was associated with better OS and CSS for NSCLC >5 cm, especially in patients treated with surgery alone. Lobectomy should be recommended as the primary option for NSCLC >5 to 7 cm, whereas its superiority was not significant over sublobectomy for NSCLC >7 cm.Conclusion: Surgery alone should be recommended as the first choice for patients with NSCLC >5 cm. The number of examined lymph nodes should be more than six in patients with NSCLC >5 cm, especially for those who undergo surgery alone. For patients with NSCLC >7 cm who could not tolerate lobectomy, sublobectomy might be an alternative surgical procedure.

show abstract

Section: Discussionsupporting

confidence: 77%

Choice of Treatment for Patients With Non–small-cell Lung Cancer >5 cm Between Surgery Alone and Surgery Plus Adjuvant Radiotherapy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Thanks to the increased popularity of health checkups and advances in imaging techniques, the detection of early-stage of lung cancer is growing, especially the GGO lesions. An anatomic segmentectomy could bring a satisfactory prognosis to patients with GGO smaller than 2 cm, both to secure an adequate surgical margin, remove distal peri-bronchial lymph nodes, and preserve pulmonary function [9,10]. However, the anatomical structure of the pulmonary segment is complex and varied, it is difficult to pinpoint pulmonary nodules, identify surgical margins, detect anatomical variations and protect intersegmental veins [11].…”

Section: Discussionmentioning

confidence: 99%

Anatomical variants of pulmonary segments and uni-portal thoracoscopic segmentectomy for lung cancer in a patient with Kartagener syndrome: a case report

Zhou

Tian

et al. 2021

Gen Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Situs inversus totalis (SIT) is an extremely uncommon congenital disease where the major organs of the body are transposed through the sagittal plane. Kartagener syndrome is a complication of SIT with immotility of bronchial cilia, bronchiectasis, and chronic sinusitis. There is no report describing patients with Kartagener syndrome who accept uni-portal segmentectomies for lung cancer in past studies. Here we report a 74-year-old female patient with both Kartagener syndrome and a small early-stage lung cancer lesion located in the apical segment of the left upper lobe (LS1). The pulmonary segment anatomy of the left upper lobe in this case, which had very rare variants, was presented and interpreted in detail. This patient underwent an anatomic segmentectomy to the LS1 and a partial excision to the left middle lobe with bronchiectasis through a single 3 cm length incision. We believe that the case can give surgeons some experience and inspiration.

show abstract

“…In recent years, more and more evidence has suggested that anatomic pulmonary segmentectomy appears to be a valid alternative to VATS lobectomy in patients with early-stage non-small cell lung cancer (9)(10)(11)(12)(13)(14). However, the location of the nodule, precise resection, and management of ISP remain significant challenges for thoracic surgeons.…”

Section: Discussionmentioning

confidence: 99%

Management of the inter-segmental plane using the “Combined Dimensional Reduction Method” is safe and viable in uniport video-assisted thoracoscopic pulmonary segmentectomy

Zheng¹,

Xu²,

Fu³

et al. 2019

Transl. Lung Cancer Res.

View full text Add to dashboard Cite

Background: The management of the intersegmental plane (ISP) is challenging during uniport videoassisted thoracoscopic (VATS) pulmonary segmentectomy. Staplers and electrocautery have been used extensively in ISP management. However, both of them have their respective drawbacks. Currently, we have provided a revised technique termed as "Combined Dimensional Reduction Method" (CDR method), for managing the ISP with combined application of ultrasonic scalpel and staplers. The study aimed to review the outcomes of patients who underwent uniport VATS segmentectomy with or without the CDR method in our institute and assess the feasibility and safety of the CDR method.Methods: From March 2017 to February 2018, 220 patients who underwent uniport VATS segmentectomy were retrospectively reviewed. By using IQQA software, pulmonary structures were reconstructed as three-dimensional (3D) images, making the targeted structures could be identified preoperatively. For the management of the ISP, in the CDR group, we firstly used the ultrasonic scalpel to trim the 3D pulmonary structure along the intersegmental demarcation, making the remaining targeted parenchyma both sufficiently thin enough and located on a 2D plane; thus, enabling easy use of staplers in managing ISP. Whereas, in the non-CDR group, we only use the staplers to manage the ISPs. The clinical characteristics, complications, and postoperative pulmonary functions were compared between the two groups.Results: Propensity score analysis generated 2 well-matched pairs of 71 patients in CDR and non-CDR groups. There was no 30-day postoperative death or readmission in either group. The CDR group was significantly associated with the shorter operative time (178.3±35.8 vs. 209.2±28.7 min) (P=0.031) and postoperative stay (4.5±2.3 vs. 5.7±4.2 days) (P=0.041), compared to the non-CDR group. Moreover, no significant difference was observed in blood loss, a period of chest tube drainage, a period of ultrafine tube drainage, and postoperative pulmonary complications between the two groups. Moreover, the recovery rate of postoperative forced expiratory volume in 1 second (FEV1) or vital capacity (VC) at 1 and 3 months after segmentectomy was comparable between them. Conclusions:The CDR method could make segmentectomy easier and more accurate, and therefore has the potential to be a viable and effective technique for uniport VATS pulmonary segmentectomy.

show abstract

POINT: Should Segmentectomy Rather Than Lobectomy Be the Operation of Choice for Early-Stage Non-small Cell Lung Cancer? Yes

Cited by 10 publications

References 14 publications

Choice of Treatment for Patients With Non–small-cell Lung Cancer >5 cm Between Surgery Alone and Surgery Plus Adjuvant Radiotherapy

Choice of Treatment for Patients With Non–small-cell Lung Cancer >5 cm Between Surgery Alone and Surgery Plus Adjuvant Radiotherapy

Anatomical variants of pulmonary segments and uni-portal thoracoscopic segmentectomy for lung cancer in a patient with Kartagener syndrome: a case report

Management of the inter-segmental plane using the “Combined Dimensional Reduction Method” is safe and viable in uniport video-assisted thoracoscopic pulmonary segmentectomy

Contact Info

Product

Resources

About