HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Antonio E. Martin-Ucar Apostolos Nakas John E. Pilling David A. Waller Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Martin-Ucar, A. E. Articles by Waller, D. A. Search for Related Content PubMed PubMed Citation Articles by Martin-Ucar, A. E. Articles by Waller, D. A. Related Collections Lung - cancer

Eur J Cardiothorac Surg 2005;27:675-679
© 2005 Elsevier Science NL

A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients

Department of Thoracic Surgery, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK

Received 1 September 2004; received in revised form 30 December 2004; accepted 3 January 2005.

^* Corresponding author. Tel.: +44 116 256 3959; fax: +44 116 236 7768. (E-mail: david.waller{at}uhl-tr.nhs.uk).

Objective: Sublobar resections may offer a method of increasing resection rates in patients with lung cancer and poor lung function, but are thought to increase recurrence and therefore compromise survival for stage I non-small cell lung cancer (NSCLC). To test this hypothesis we have compared the long-term outcome from lobectomy and anatomical segmentectomy in high-risk cases as defined by predicted postoperative FEV₁ (ppoFEV₁) less than 40%. Methods: Over a 7-year period 55 patients (27% of all resections for stage I NSCLC) with ppoFEV₁<40% underwent resection of stage I NSCLC. The 17 patients who underwent anatomical segmentectomy were individually matched to 17 patients operated by lobectomy on the bases of gender, age, use of VATS, tumour location and respiratory function. We compared their perioperative course, tumour recurrence and survival. Results: There were no significant differences in hospital mortality (one case in each group), complications or hospital stay. Overall 5-year survival was 69%. There were no differences in recurrence rates (18% in both groups) or survival (64% after lobectomy and 70% after segmentectomy). There was preservation of pulmonary function after segmentectomy (median gain of 12%) compared to lobectomy (median loss of 12%) (P=0.02). Conclusions: Anatomical segmentectomy allowed for surgical resection in patients with stage I NSCLC and impaired respiratory reserve without compromising oncological results but with preservation in respiratory function.

Key Words: Lung resection • Outcomes • Thoracic surgery

This article has been cited by other articles:

				A. Brunelli, A. Charloux, C. T. Bolliger, G. Rocco, J-P. Sculier, G. Varela, M. Licker, M. K. Ferguson, C. Faivre-Finn, R. M. Huber, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy) Eur. Respir. J., July 1, 2009; 34(1): 17 - 41. [Abstract] [Full Text] [PDF]

				A. Kilic, M. J. Schuchert, B. L. Pettiford, A. Pennathur, J. R. Landreneau, J. P. Landreneau, J. D. Luketich, and R. J. Landreneau Anatomic Segmentectomy for Stage I Non-Small Cell Lung Cancer in the Elderly. Ann. Thorac. Surg., June 1, 2009; 87(6): 1662 - 1668. [Abstract] [Full Text] [PDF]

				M. Shapiro, T. S. Weiser, J. P. Wisnivesky, C. Chin, M. Arustamyan, and S. J. Swanson Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer. J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1388 - 1393. [Abstract] [Full Text] [PDF]

				A. Watanabe, S. Ohori, S. Nakashima, T. Mawatari, N. Inoue, Y. Kurimoto, and T. Higami Feasibility of video-assisted thoracoscopic surgery segmentectomy for selected peripheral lung carcinomas Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 775 - 780. [Abstract] [Full Text] [PDF]

				R. Rami-Porta and M. Tsuboi Sublobar resection for lung cancer Eur. Respir. J., February 1, 2009; 33(2): 426 - 435. [Abstract] [Full Text] [PDF]

				C. J.A. Haasbeek, S. Senan, E. F. Smit, M. A. Paul, B. J. Slotman, and F. J. Lagerwaard Critical Review of Nonsurgical Treatment Options for Stage I Non-Small Cell Lung Cancer Oncologist, March 1, 2008; 13(3): 309 - 319. [Abstract] [Full Text] [PDF]

				P.-K. Hsu, H.-C. Huang, C.-C. Hsieh, H.-S. Hsu, Y.-C. Wu, M.-H. Huang, and W.-H. Hsu Effect of Formalin Fixation on Tumor Size Determination in Stage I Non-Small Cell Lung Cancer Ann. Thorac. Surg., December 1, 2007; 84(6): 1825 - 1829. [Abstract] [Full Text] [PDF]

				B. Z. Atkins, D. H. Harpole Jr, J. H. Mangum, E. M. Toloza, T. A. D'Amico, and W. R. Burfeind Jr Pulmonary Segmentectomy by Thoracotomy or Thoracoscopy: Reduced Hospital Length of Stay With a Minimally-Invasive Approach Ann. Thorac. Surg., October 1, 2007; 84(4): 1107 - 1113. [Abstract] [Full Text] [PDF]

				M. J. Schuchert, B. L. Pettiford, S. Keeley, T. A. D'Amato, A. Kilic, J. Close, A. Pennathur, R. Santos, H. C. Fernando, J. R. Landreneau, et al. Anatomic Segmentectomy in the Treatment of Stage I Non-Small Cell Lung Cancer Ann. Thorac. Surg., September 1, 2007; 84(3): 926 - 933. [Abstract] [Full Text] [PDF]

				W. J. Scott, J. Howington, S. Feigenberg, B. Movsas, and K. Pisters Treatment of Non-small Cell Lung Cancer Stage I and Stage II: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 234S - 242S. [Abstract] [Full Text] [PDF]

				A. E Martin-Ucar, K. R Fareed, A. Nakas, P. Vaughan, J. G Edwards, and D. A Waller Is the initial feasibility of lobectomy for stage I non-small cell lung cancer in severe heterogeneous emphysema justified by long-term survival? Thorax, July 1, 2007; 62(7): 577 - 580. [Abstract] [Full Text] [PDF]

				W. Sienel, C. Stremmel, A. Kirschbaum, L. Hinterberger, E. Stoelben, J. Hasse, and B. Passlick Frequency of local recurrence following segmentectomy of stage IA non-small cell lung cancer is influenced by segment localisation and width of resection margins -- implications for patient selection for segmentectomy Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 522 - 528. [Abstract] [Full Text] [PDF]

				M. Okada, T. Mimura, J. Ikegaki, H. Katoh, H. Itoh, and N. Tsubota A novel video-assisted anatomic segmentectomy technique: Selective segmental inflation via bronchofiberoptic jet followed by cautery cutting J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 753 - 758. [Abstract] [Full Text] [PDF]

				M. Okada, T. Koike, M. Higashiyama, Y. Yamato, K. Kodama, and N. Tsubota Radical sublobar resection for small-sized non small cell lung cancer: A multicenter study J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 769 - 775. [Abstract] [Full Text] [PDF]

				J. C. Garzon, C. S.H. Ng, A. D.L. Sihoe, A. V. Manlulu, R. H.L. Wong, T. W. Lee, and A. P.C. Yim Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function Ann. Thorac. Surg., June 1, 2006; 81(6): 1996 - 2003. [Abstract] [Full Text] [PDF]