Original article: general thoracicIs segmentectomy with lymph node assessment an alternative to lobectomy for non–small cell lung cancer of 2 cm or smaller?
Section snippets
Patients and methods
Between June 1984 and December 1998, 1,453 patients underwent curative operation for primary non–small cell lung cancer. Curative operation was defined as the complete removal of the ipsilateral hilar and mediastinal lymph nodes together with the primary tumor including negative bronchial margins. Of the 1,453, 139 patients underwent lobectomy for cT1N0M0 tumor of 2 cm or less in diameter. After specimens were fixed and cut into slices 1 cm thick, they were investigated macroscopically and
Analysis of lobectomy for cT1N0M0 tumor of 2 cm or less in diameter
There were a total of 139 patients in this group (88 men and 51 women, mean age = 62.5 ± 9.2 years). The histopathologic diagnosis was adenocarcinoma in 103 patients, squamous cell carcinoma in 33, large cell carcinoma in 2, and carcinoid in 1. The pathologic nodal status was as follows: pN0 in 107 patients, pN1a in 2, pN1b in 10, and pN2 in 20. Two patients (1.4%) had N1a disease (involvement of only intralobar nodes), which was not detected during the procedure. All of the involved nodes were
Comment
In 1995, a prospective randomized trial of lobectomy versus limited resection for T1N0 non–small cell lung cancer less than 3 cm in diameter demonstrated that limited resection should not be considered because of its higher death rate and local recurrence [13]. We considered this study to have room for reconsideration. In the invited commentary at the end of that report, Drs Peters and Benfield respectively took a critical view of the conclusions [13]. It was noteworthy that this study included
References (23)
- et al.
Segmental resection for lung carcinoma
J Thorac Cardiovasc Surg
(1973) - et al.
Limited resection of bronchogenic carcinoma in the patient with marked impairment of pulmonary function
Ann Thorac Surg
(1987) - et al.
Survival after conservative resection for T1N0M0 non-small cell lung cancer
Ann Thorac Surg
(1990) - et al.
Segmentectomy versus lobectomy in patients with stage I pulmonary carcinoma
J Thorac Cardiovasc Surg
(1994) - et al.
Intentional limited resection for selected patients with T1N0M0 non-small-cell lung cancer
J Thorac Cardiovasc Surg
(1997) - et al.
Surgical approach for multiple primary lung carcinomas
J Thorac Cardiovasc Surg
(1998) - et al.
Extended sleeve lobectomy for lung cancer; the avoidance of pneumonectomy
J Thorac Cardiovasc Surg
(1999) - et al.
Survival related to lymph node involvement in lung cancer after sleeve lobectomy compared with pneumonectomy
J Thorac Cardiovasc Surg
(2000) - et al.
Current morbidity, mortality, and survival after bronchoplastic procedures for malignancy
Ann Thorac Surg
(1992) - et al.
Proposal for reasonable mediastinal lymphadenectomy in bronchogenic carcinomas—role of subcarinal node in selective dissection
J Thorac Cardiovasc Surg
(1998)
Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer
Ann Thorac Surg
Cited by (276)
Tumor distance from the mediastinum predicts N2 upstaging in clinical stage I lower-lobe non–small cell lung cancer
2024, Journal of Thoracic and Cardiovascular SurgeryPulmonary Segmentectomy: A New Standard of Care in Patients with Non-Small Cell Cancer
2022, Journal of Cardiothoracic and Vascular AnesthesiaSegmentectomy for Inner Location Small-Sized Non-Small Cell Lung Cancer: Is It Feasible?
2022, Annals of Thoracic SurgerySegmentectomy in Lung Cancer as a New Standard of Treatment: Can Less Be More?
2022, Archivos de Bronconeumologia