Chest
Original ResearchLung CancerSurvival Following Lobectomy and Limited Resection for the Treatment of Stage I Non-small Cell Lung Cancer ≤ 1 cm in Size: A Review of SEER Data
Section snippets
Materials and Methods
Patients were selected from the Surveillance, Epidemiology, and End Results (SEER) program, which has collected clinicopathologic data on all incident cancer cases in specified geographic areas of the United States since 1972. The SEER program is a population-based cancer registry sponsored by the National Cancer Institute that routinely collects information on the incidence and survival rates of cancer in 18 areas of the United States. The SEER population is highly representative in terms of
Results
The analysis included 2,090 patients with stage I NSCLC ≤ 1 cm in size. Of these, 688 (33%) underwent limited resection. The median follow-up time for the entire cohort was 37 months; the minimal follow-up (for patients diagnosed in December 2004) was 1 year. Patients ≤ 60 years of age had a median follow-up time of 44 months, compared with 38 months for patients 60 to 70 years of age, and 31 months for patients > 70 years of age. Overall, 1,351 patients (64%) were alive at the end of the study
Discussion
Although it has been reported previously that patients with small-sized stage IA NSCLC can undergo resections of less than one lobe without leading to worse survival outcomes, controversy still remains regarding the treatment of choice for these tumors. In this study, we did not find a significant difference in survival among patients with stage IA NSCLC ≤ 1 cm in size treated with lobectomy vs limited resection. Our findings suggest that limited resection may be considered for the treatment of
Conclusions
In summary, our results suggest that there are similar survival rates among patients receiving limited resection vs lobectomy for ≤ 1 cm stage IA tumors, regardless of age. When our findings are viewed along with previously reported data demonstrating that limited resection is associated with fewer postoperative complications and better lung function, it would seem that limited resection may be preferable for tumors ≤ 1 cm in size, when technically possible. However, for a definitive
References (25)
- et al.
Patterns of surgical care of lung cancer patients
Ann Thorac Surg
(2005) - et al.
Segmental resection spares pulmonary function in patients with stage I lung cancer
Ann Thorac Surg
(2004) - et al.
Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study
J Thorac Cardiovasc Surg
(2006) - et al.
Segmentectomy versus lobectomy in patients with stage I pulmonary carcinoma. Five-year survival and patterns of intrathoracic recurrence
J Thorac Cardiovasc Surg
(1994) - et al.
Wedge resection vs lobectomy: 10-year survival in stage I primary lung cancer
Chest
(2007) - et al.
Surgical treatment of non-small cell lung cancer 1 cm or less in diameter
Ann Thorac Surg
(2002) Revisions in the International System for Staging Lung Cancer
Chest
(1997)- et al.
Postoperative survival and the number of lymph nodes sampled during resection of node-negative non-small cell lung cancer
Chest
(2005) - et al.
Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database
Chest
(2005) - et al.
Impact of tumor size on survival in stage IA non-small cell lung cancer: a case for subdividing stage IA disease
Lung Cancer
(2003)
The effect of tumor size on curability of stage I non-small cell lung cancers
Chest
Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection
J Thorac Cardiovasc Surg
Cited by (0)
For editorial comment see page 481.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).