Tags

Type your tag names separated by a space and hit enter

Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer.
J Thorac Cardiovasc Surg. 2009 Jun; 137(6):1388-93.JT

Abstract

OBJECTIVE

As thoracoscopic lobectomy becomes widely applied for treatment of non-small cell lung cancer, thoracoscopic segmentectomy remains controversial for patients with small stage I lung cancers. Questions remain regarding safety, morbidity, mortality, and recurrence rate. This study compared outcomes between thoracoscopic segmentectomy and lobectomy.

METHODS

Retrospective review was undertaken of patients who underwent thoracoscopic segmentectomy or lobectomy for clinical stage I non-small cell lung cancer between January 2002 and February 2008. Indications for segmentectomy were tumor smaller than 3 cm, limited pulmonary reserve, comorbidities, and peripheral tumor location.

RESULTS

Thirty-one patients underwent segmentectomy and 113 underwent lobectomy. Patients after segmentectomy had worse mean forced expiratory volume in 1 second than after lobectomy (83% vs 92%, P = .04). There were no differences in mean number of nodes (10) and nodal stations (5) resected. Segmentectomy and lobectomy groups had similar median chest tube durations (2 vs 3 days, P = .18), stays (both 4 days), total complications, recurrence rates, and survivals at mean follow-ups of 22 and 21 months, respectively. Lobectomy group had 1 30-day death; segmentectomy group had none. There were 5 (17.2%) recurrences after segmentectomy and 23 (20.4%) after lobectomy (P = .71), with locoregional recurrence rates of 3.5% and 3.6%, respectively.

CONCLUSION

Thoracoscopic segmentectomy is a safe option for experienced thoracoscopic surgeons treating patients with small stage I lung cancers. No significant difference in oncologic outcome was seen between thoracoscopic segmentectomy and thoracoscopic lobectomy. Lymph node dissection could be performed as effectively during segmentectomy as lobectomy.

Authors+Show Affiliations

Department of Surgery, The Mount Sinai Medical Center, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19464454

Citation

Shapiro, Mark, et al. "Thoracoscopic Segmentectomy Compares Favorably With Thoracoscopic Lobectomy for Patients With Small Stage I Lung Cancer." The Journal of Thoracic and Cardiovascular Surgery, vol. 137, no. 6, 2009, pp. 1388-93.
Shapiro M, Weiser TS, Wisnivesky JP, et al. Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer. J Thorac Cardiovasc Surg. 2009;137(6):1388-93.
Shapiro, M., Weiser, T. S., Wisnivesky, J. P., Chin, C., Arustamyan, M., & Swanson, S. J. (2009). Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer. The Journal of Thoracic and Cardiovascular Surgery, 137(6), 1388-93. https://doi.org/10.1016/j.jtcvs.2009.02.009
Shapiro M, et al. Thoracoscopic Segmentectomy Compares Favorably With Thoracoscopic Lobectomy for Patients With Small Stage I Lung Cancer. J Thorac Cardiovasc Surg. 2009;137(6):1388-93. PubMed PMID: 19464454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer. AU - Shapiro,Mark, AU - Weiser,Todd S, AU - Wisnivesky,Juan P, AU - Chin,Cynthia, AU - Arustamyan,Michael, AU - Swanson,Scott J, Y1 - 2009/04/11/ PY - 2008/10/25/received PY - 2008/12/18/revised PY - 2009/02/01/accepted PY - 2009/5/26/entrez PY - 2009/5/26/pubmed PY - 2009/6/10/medline SP - 1388 EP - 93 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 137 IS - 6 N2 - OBJECTIVE: As thoracoscopic lobectomy becomes widely applied for treatment of non-small cell lung cancer, thoracoscopic segmentectomy remains controversial for patients with small stage I lung cancers. Questions remain regarding safety, morbidity, mortality, and recurrence rate. This study compared outcomes between thoracoscopic segmentectomy and lobectomy. METHODS: Retrospective review was undertaken of patients who underwent thoracoscopic segmentectomy or lobectomy for clinical stage I non-small cell lung cancer between January 2002 and February 2008. Indications for segmentectomy were tumor smaller than 3 cm, limited pulmonary reserve, comorbidities, and peripheral tumor location. RESULTS: Thirty-one patients underwent segmentectomy and 113 underwent lobectomy. Patients after segmentectomy had worse mean forced expiratory volume in 1 second than after lobectomy (83% vs 92%, P = .04). There were no differences in mean number of nodes (10) and nodal stations (5) resected. Segmentectomy and lobectomy groups had similar median chest tube durations (2 vs 3 days, P = .18), stays (both 4 days), total complications, recurrence rates, and survivals at mean follow-ups of 22 and 21 months, respectively. Lobectomy group had 1 30-day death; segmentectomy group had none. There were 5 (17.2%) recurrences after segmentectomy and 23 (20.4%) after lobectomy (P = .71), with locoregional recurrence rates of 3.5% and 3.6%, respectively. CONCLUSION: Thoracoscopic segmentectomy is a safe option for experienced thoracoscopic surgeons treating patients with small stage I lung cancers. No significant difference in oncologic outcome was seen between thoracoscopic segmentectomy and thoracoscopic lobectomy. Lymph node dissection could be performed as effectively during segmentectomy as lobectomy. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/19464454/Thoracoscopic_segmentectomy_compares_favorably_with_thoracoscopic_lobectomy_for_patients_with_small_stage_I_lung_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(09)00161-5 DB - PRIME DP - Unbound Medicine ER -