In a nutshell
The authors aimed to analyze the effect of different surgical procedures on survival of stage I non-small cell lung cancer (NSCLC) patients.
Some background
NSCLC is the most common type of lung cancer. In stage I (early stage) NSCLC, surgery is the treatment of choice. There are three main surgical procedures that could be performed to remove part of a lung. Lobectomy is the surgical removal of an entire lobe of a lung (the lungs have five lobes, three in the right and two in the left lung). Segmentectomy is removal of a section of a lobe of a lung. Wedge resection is removal of a wedge (triangular)-shaped piece of a lung that is cancerous. Together, the latter two procedures are often termed sublobectomy. Depending upon the size of the tumor, one of these surgical procedures is carried out. Generally, lobectomy is carried out when tumor size in stage I NSCLC is greater than 3 cm.
Methods & findings
A total of 42 studies enrolling 21,926 patients, were included in this analysis. Of these, 15,219 were treated with lobectomy and the remaining 6,707 received either segmentectomy or wedge resection.
The risk of death from any cause or death from lung cancer was 23% higher in those who underwent sublobectomy compared to those who underwent lobectomy. In particular, survival was better in patients with stage I cancer where the tumor was < 2 cm or patients greater than 65 years of age who underwent lobectomy compared to sublobectomy. The risk of cancer returning was 32% higher in those who underwent sublobectomy compared to those who underwent lobectomy.
When sublobectomy was the preferred method, segmentectomy showed better survival results over wedge resection.
The bottom line
The authors concluded that lobectomy provided better survival when compared to either segmentectomy or wedge resection.
Published By :
Surgical oncology
Date :
Oct 16, 2014
