Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function

Garzón, Juan Carlos; Ng, Calvin S.H.; Sihoe, Alan D.L.; Manlulu, Anthony V.; Wong, Randolph H.L.; Lee, Tak Wai; Yim, Anthony P.C.

doi:10.1016/j.athoracsur.2006.01.038

Cited by 67 publications

(45 citation statements)

References 26 publications

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“…The 5-yr survival rates of lobectomy and sublobar resection were equivalent, except in six studies [25,27,35,36,40,42]. WARREN et al [25] compared the survival of 103 patients who had undergone lobectomy with the survival of 66 patients who had undergone segmentectomy: 5-yr survival was significantly better for those who had undergone lobectomy (65% versus 45%).…”

Section: Survival and Recurrencementioning

confidence: 99%

“…The series of GARZON et al [36] included 25 patients with poor lung function who underwent either video-assisted thoracic surgery (VATS) lobectomy (13 patients) or VATS wedge resection (12 patients). Follow-up was very short (median 15.1 months), but within 2 yrs after the operation, five patients had died, four of them from cancer.…”

Section: Survival and Recurrencementioning

confidence: 99%

“…SUBLOBAR RESECTIONS FOR SMALL SOLID AND PARTLY SOLID PERIPHERAL TUMOURS Indications Table 1 shows the most relevant data from 20 studies comparing lobectomy with sublobar resection [8,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. All but three were retrospective: one was a prospective but nonrandomised study [28] and two were prospective observational studies [20,34].…”

Section: Upper Lobementioning

confidence: 99%

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Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2009

Eur Respir J

102

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Sublobar resection for small lung cancers has been debated frequently and is still a controversial issue. The only randomised trial comparing lobectomy with sublobar resections found a significantly higher recurrence rate for the latter, but failed to show significant differences in survival, although survival was better for the lobectomy group. One meta-analysis and several nonrandomised comparisons have confirmed these results. In general, lobectomy and sublobar resections have similar 5-yr survival rates. Local recurrence after wedge resection is higher than after segmentectomy. However, for patients aged .71 yrs, lobectomy and wedge resection are associated with similar survival. For tumours of f2 cm, segmentectomy is equivalent to lobectomy, but survival after segmentectomy is worse if performed for larger tumours. For both segmentectomy and wedge resection, tumour margins should be o1 cm wide to avoid recurrence. For pure bronchioloalveolar carcinoma of f2 cm, diagnosed intraoperatively with certainty, sublobar resection seems equivalent to lobectomy, and because there is no nodal involvement, systematic nodal dissection may not be necessary. In case of doubt, however, lobectomy with systematic nodal dissection will ensure complete resection and adequate staging. More randomised trials are needed to confirm all these issues.

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Section: Survival and Recurrencementioning

confidence: 99%

Section: Survival and Recurrencementioning

confidence: 99%

Section: Upper Lobementioning

confidence: 99%

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Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2009

Eur Respir J

102

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“…To this end, some encouraging studies are already emerging. In one study from Hong Kong, VATS lobar and sublobar resection with curative intent was performed in patients with forced expiratory volume in one second on spirometry (FEV1) of <0.8L and/or <50% predicted (Garzon et al, 2006). Patients with such poor lung function would have traditionally been refused any form of curative major lung surgery.…”

Section: Current Challenges Emerging Solutionsmentioning

confidence: 99%

The Evolution of VATS Lobectomy

Sihoe¹

2012

Topics in Thoracic Surgery

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“…Whether a patient accepts these thresholds for resection, as given above, has to be discussed individually taking into account both risks and benefits for standard surgical resection of lung cancer. Also less conventional treatment options, such as minimal invasive techniques with smaller muscle sparing incisions and less rib damage [14,15,28], sublobar resections and nonsurgical options, such as radiotherapy and radiofrequency ablation, should be discussed [19]. Patients can develop both cardiac and pulmonary complications after pulmonary resections including arrhythmias, myocardial infarctions, cerebrovascular accidents, pulmonary embolisms, pneumonias, empyemas, airway dehiscence and bronchopleural fistulas [29].…”

Section: Pre-operative Considerations For Pulmonary Resectionmentioning

confidence: 99%

Pre-operative pulmonary evaluation of lung cancer patients: a review of the literature

Tilburg

Stam²,

Hoogsteden³

et al. 2009

Eur Respir J

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Complete anatomical resection of the primary tumour is still the standard of care in patients with early stage lung cancer. Because these patients are usually smokers who also suffer from chronic obstructive pulmonary disease, regional differences in pulmonary function due to lung tissue destruction exist.The purpose of the present article is to evaluate the currently available guidelines and to discuss novel methods for the pre-operative functional and anatomical pulmonary evaluation in lung cancer patients.Despite the fact that knowledge on the pre-operative evaluation of the pulmonary function has substantially increased during the past decade, the majority of the studies are small, underpowered and, with exception of a proposed algorithm, not prospectively validated in independent cohorts.The future harmonisation of guidelines is required and novel imaging techniques should be incorporated in the pre-operative evaluation in chronic obstructive pulmonary disease patients with borderline pulmonary function.

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Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function

Cited by 67 publications

References 26 publications

Sublobar resection for lung cancer

Sublobar resection for lung cancer

The Evolution of VATS Lobectomy

Pre-operative pulmonary evaluation of lung cancer patients: a review of the literature

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