CALGB140503 study: Is sublobectomy the standard procedure for early peripheral lung cancer?
- VernacularTitle:CALGB140503研究：亚肺叶切除是早期周围型肺癌的标准术式？
- Author:
Sikai WU
1
,
2
;
Zimin WANG
1
,
2
;
Hua SUN
1
,
2
;
Chengchu ZHU
1
,
2
;
Jianfei SHEN
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Taizhou Hospital, Zhejiang University, Key Laboratory of Minimally Invasive Techniques &
2. Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Wenzhou, 325035, Zhejiang, P. R. China
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer;
lobectomy;
sublobectomy;
clinical prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(08):1097-1101
- CountryChina
- Language:Chinese
-
Abstract:
While lobectomy is the standard surgical procedure for early-stage non-small cell lung cancer (NSCLC), sublobectomy (segmentectomy/wedge resection) has been gaining progress in early-stage peripheral NSCLC in recent years because it preserves more lung parenchyma and has the advantages of good postoperative lung function, relatively less trauma, and faster recovery. However, there has been a lack of standardized randomized clinical trials to study the survival benefits of sublobectomy. The results of a high-profile study from the USA, CALGB140503, have been the subject of intense industry debate since its presentation at the 2022 World Conference on Lung Cancer (IASLC WCLC 2022). The study, which was published in The New England Journal of Medicine on February 9, 2023, was designed to investigate whether sublobectomy was not inferior to lobectomy in terms of survival in patients with early-stage peripheral NSCLC (tumor diameter≤2 cm). The results showed that sublobectomy was not worse than lobectomy for survival in patients with T1aN0M0 peripheral NSCLC with tumor diameter≤2 cm and pathologically confirmed negative hilar and mediastinal lymph nodes. Sublobectomy, including anatomical segmentectomy and wedge resection is an effective NSCLC treatment. The results of this study provide strong evidence for the improved outcomes of sublobectomy in terms of lung function protection and are expected to promote the further use of sublobectomy. However, given the limitations of this study, whether sublobectomy, especially wedge resection, can become a standard procedure still needs to be explored. This paper presents an interpretation of this study and we invite experts in the field to discuss its usefulness in guiding clinical practice and summarise its limitations.
