Comparing lobectomy and sublobar resection for older patients with stage 1A NSCLC

The study was carried out to assess the difference in outcomes between lobectomy (LE) and sub-lobar resection (SLR) for older patients with stage I non-small-cell lung cancer (NSCLC). The authors found that both surgeries had similar outcomes in these patients. 

NSCLC is responsible for 85% of lung cancer diagnoses worldwide. NSCLC can be difficult to treat. Detection rates of early-stage lung cancer have increased recently due to better screening programs. Surgical removal of tumors plays an important role in the management of NSCLC. LE involves removing one lobe of the lung where the cancer exists.

Surgeons are often reluctant to recommend LE as a form of treatment in patients aged 70 or older due to increased surgery risks. Less invasive surgeries such as SLR are preferred for these patients. SLR involves removing a smaller portion of a lobe of the lung where the cancer exists. However, it is not known whether SLR has good outcomes compared to LE in older patients with NSCLC.

There were a total of 3504 patients aged 70 or older involved in this trial. Half of the patients underwent LE and half underwent SLR.

The average length of lung cancer-specific survival (duration from treatment to death from lung cancer) in the LE group was 91 months compared to 80 months in the SLR group. This was not considered statistically significant.

Poorer survival was associated with older age, squamous cell cancer type, larger tumors, and poorer differentiated cancer.

The authors found that LE and SLR had similar outcomes in the treatment of early-stage NSCLC in older patients.

This study was based on medical records. Some information regarding the tumor and other therapies given before and/or after surgery were missing. This might have influenced the results. Further controlled studies are needed.