Sublobar resection for clinical stage I nonsmall cell lung cancers

Abstract

Aim: We investigated outcomes of sublobar resection in patients with clinical early-stage nonsmall cell lung cancers. Patients and Methods: Patients who underwent surgical resection between January 2002 and June 2013 were reviewed. The clinical data, surgical approach, and outcome were analyzed with mean follow-up of 108 months. Results: Of 597 patients, 108 (18.1%) underwent sublobar resection. The 5-year overall survival (OS) and disease-free survival rate for this group were 76.2% and 70.3%, respectively, compared with 79.7% and 73.0% for those undergoing anatomic resection (P = 0.709 and 0.618). After stratifying for tumor size <2 cm, 233 patients with T1a lesions were enrolled in this study. The 5-year OS and disease-free survival rate for 69 patients who underwent sublobar resection were 96% and 87%, respectively, compared with 93.4% and 89.7% for those undergoing anatomic resection (P = 0.760 and 0.868). The local recurrence rate was 3% in the sublobar resection group and 8.5% in the anatomic resection group. There were no significant differences in age, gender, histopathology type, maximum standard uptake value, lymphovascular space invasion, visceral pleural invasion, and epidermal growth factor receptor status, except in the grade of tumor differentiation and numbers of dissected lymph nodes: 13.16 ± 6.62 in the anatomic resection group and 7.34 ± 4.91 in the sublobar resection group (P < 0.01). In the sublobar resection group, 28 patients underwent segmentectomy without local recurrence during follow-up. Conclusions: The oncologic outcomes of sublobar resection were similar to anatomic resection in these patients; lymph node sampling might not compromise surgical outcomes. Further large-scale studies are necessary to clarify the difference in clinical outcome between segmentectomy and wedge resection.

Keywords

• Lung cancer
• prognosis
• surgery