Korean J Thorac Cardiovasc Surg.  2011 Feb;44(1):51-57.

Outcome of Limited Resection for Lung Cancer

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Korea.
  • 2Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Korea. jheon@snu.ac.kr
  • 3Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Korea.

Abstract

BACKGROUND
Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. MATERIAL AND METHODS: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed.
RESULTS
Mean age at operation was 66.0+/-12.4 years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of 28.0+/-17.8 months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (> or =95%), or in small solid lesions (< or =2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of 31.7+/-11.6 months, no patient developed recurrence.
CONCLUSION
Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.

Keyword

Lung neoplasm; Risk; Lung surgery

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Follow-Up Studies
Glass
Humans
Lung
Lung Neoplasms
Lymph Node Excision
Male
Mastectomy, Segmental
Medical Records
Pneumonectomy
Retrospective Studies
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