Lobectomy preferred option for early-stage NSCLC
medwireNews: Research published in the Journal of Clinical Oncology suggests that lobectomy, rather than limited resection, should be the treatment of choice for all suitable early-stage non-small-cell lung cancer (NSCLC) patients.
The team’s analysis of US Surveillance, Epidemiology, and End Results data showed that overall survival (OS) and lung cancer-specific survival (LCSS) were significantly improved for the 11,520 patients with primary T1aN0M0 tumours no bigger than 2 cm who underwent lobectomy than for their 4240 counterparts treated with segmentectomy or wedge resection (hazard ratios of 1.71 and 1.66, respectively).
The survival advantage of lobectomy over limited resection was maintained for the subgroup of patients with lesions no larger than 1 cm and between 1 and 2 cm (ie, T1a and T1b tumours as per the most recent recommendations of the International Association for the Study of Lung Cancer staging project).
Among participants who underwent sublobar resection, OS and LCSS were comparable for segmentectomy and wedge resection for tumours of 1 cm or smaller. However, segmentectomy emerged as the superior procedure for individuals with lesions between 1 and 2 cm, report Jianxing He (The First Affiliated Hospital of Guangzhou Medical University, China) and colleagues.
And they conclude: “For patients in whom lobectomy is unsuitable, segmentectomy should be recommended for NSCLC > 1 to 2 cm, whereas surgeons could rely on surgical skills and the patient profile to decide between segmentectomy and wedge resection for NSCLC ≤ 1 cm.”
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