Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11599

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    P2.07-004 - Wedge Resection and Segmentectomy in Patients with Stage I Non-small Cell Lung Cancer (ID 344)

    09:30 - 09:30  |  Author(s): G. Kalavrouziotis
    • Abstract

    Background
    The use of resections lesser than lobectomy as definitive management of a stage I non-small cell lung carcinoma (NSCLC) is a topic that creates controversy in the global medical community. To describe the current conclusions concerning the relative indications of each type of resection in the surgical treatment of stage I NSCLC, as well as the international results from their application concerning the local recurrence, disease-free survival, and five-year survival rates.

    Methods
    Thirty four prospective and retrospective studies registered in PubMed and Scopus electronic databases during the last twenty five years were reviewed. Bibliographies and handsearching of journals were used to identify trials. Studies’ authors, citations, objectives, and results were extracted. No meta-analysis was used. Validation of results was discussed.

    Results
    Segmentectomies were superior to wedge resections in terms of local recurrence and cancer-related survival rates. Sublobar resections were superior to lobectomy concerning preservation of pulmonary parenchyma. It was recommended that high-risk patients undergo segmentectomy. Lobectomies were superior to segmentectomies only for tumors >2 cm (T2bN0M0) as regarding disease-free and overall 5-year survival. There was no significant difference for tumors <2 cm in most studies. Free surgical margins were crucial for local control rates. Systematic lymphadenectomy was mandatory regardless of type of resection. In cases of pure bronchoalveolar carcinoma, segmentectomy was recommended. Shorter hospital stay was achieved with sublobar resections.

    Conclusion
    The choice of type of resection for T1aN0M0 tumors should rely on specific patient and tumor characteristics. Patient age and tumor size are the most important factors. Further prospective randomized trials are needed to determine minimal resections in early lung cancer patients.