Controversy over surgical modalities for early non-small cell lung cancer
- VernacularTitle:早期非小细胞肺癌外科手术方式的争议
- Author:
Qiang WU
1
,
2
,
3
,
4
;
Hao KONG
;
Boyou ZHANG
1
,
2
,
3
,
4
;
Banglun QIAN
5
;
Yi LU
6
,
7
,
8
;
Fei SUN
6
,
7
,
8
;
Hongcan SHI
3
,
4
,
6
,
8
,
9
Author Information
1. 1. Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, P. R. China
2. 2. Key Laboratory of Integrative Medicine in Geriatrics Control of Jiangsu Province, Yangzhou University, Yangzhou, 225009, P. R. China
3. 3. Northern Jiangsu People&rsquo
4. s Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, 225001, P. R. China
5. Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, P. R. China
6. 2. Key Laboratory of Integrative Medicine in Geriatrics Control of Jiangsu Province, Yangzhou University, Yangzhou, 225009, P. R. China
7. 4. Clinical Medical College of Yangzhou University, Yangzhou, 225009, P. R. China
8. 5. Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
9. 4. Clinical Medical College of Yangzhou University, Yangzhou, 225009, P. R. China
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer;
lobectomy;
segmetectomy;
wedge resection;
stereotactic body radiation therapy (SBRT);
image-guided thermal ablation (IGTA)
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(08):1066-1072
- CountryChina
- Language:Chinese
-
Abstract:
Lobectomy and systematic nodules resection has been the standard surgical procedure for non-small cell lung cancer (NSCLC). However, increased small-size lung cancer has been identified with the widespread implementation of low-dose computed tomography (LDCT) screening, and it is controversial whether it is proper to choose lobar resection for the pulmonary nodules. Numerous retrospective researches and randomized clinical trials, such as JCOG0201, JCOG0804/WJOG4507L, JCOG0802 and CALGB/Alliance 140503, revealed that the sublobar resection was safe and effective for NSCLC with maximum tumor diameter≤2 cm and with consolidation tumor ratio (CTR)≤0.25, and that segmentectomy was superior to lobectomy with significant differences in 5-year overall survival rate and respiratory function for patients with small-size (≤2 cm, CTR>0.5) NSCLC and should be the standard surgical procedure. It is the principle for multiple primary lung cancer that priority should be given to primary lesions with secondary lesions considered, and it is feasible to handle the multiple lung nodules based on the patients' individual characteristics.
