As effective as lobectomy in some early-stage lung cancers

Thomas Bauer

Dr. Thomas Bauer, President of Surgery at Hackensack Meridian Jersey Shore University Medical Center, is part of the international multicenter research team

Researchers at Hackensack Meridian Jersey Shore University Medical Center participated in a multicenter international clinical trial showing that removing just a portion of the lung containing early-stage lung cancer was successful in reducing lung lobes without compromising recurrence or overall risk. It has been shown to be as effective as total excision. survival. The results of a phase III study published in his February 9, 2023 issue of the New England Journal of Medicine show the standard for selected patients with small tumors in the lung periphery that have not spread outside the lung. Treatment may change. original location.

“The results of this clinical trial are highly significant and have the potential to change the way we manage early-stage lung cancer,” said lead author. This may be particularly beneficial for patients with compromised lung function.”

Lobectomy – removal of a lung lobe – is the standard surgical approach for patients with stage 1 non-small cell lung cancer (NSCLC) that has not spread to nearby lymph nodes or other parts of the body. However, newer imaging and staging techniques, such as lung cancer screening with low-dose CT scans, are now detecting smaller and earlier tumors. Surgeons question whether some of these patients can undergo a sublobar resection (removal of only the tumor and some of the tissue around it, rather than the entire lung lobe) without compromising outcome. I’ve been

In this study, investigators randomly assigned 697 patients with peripheral stage 1 node-negative NSCLC (mainly adenocarcinoma and squamous cell carcinoma) to undergo lobectomy (357 patients) or sublobectomy (357 patients). 340 patients). All patients had tumors 2 cm or smaller than her in size. After a median follow-up of 7 years, recurrence and overall survival rates were similar between he two groups. The 5-year recurrence rate (disease-free survival) was 64.1% after lobectomy and 63.6% after sublobectomy. Five-year overall survival rates were 78.9% and 80.3%, respectively.

Patients in the lobectomy group had a forced expiratory volume rate (a measure of lung function) that was 2 percentage points better than the lobectomy group. Forced vital capacity, another measure of respiratory function, was also slightly better in the sublobar resection patients.

The authors concluded that sublobectomy is an effective surgical treatment for people with stage 1 node-negative NSCLC and small tumors. They suggest that these findings are likely to increase as the proportion of patients with early-stage lung cancer increases with expanded lung cancer screening practices, increasing the number of patients with early-stage lung cancer, and sublobectomy may become the surgical procedure of choice. added that it will become more important. Approach goes up.

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