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sublobar lobectomy

Maria F Echavarria, Anna M Cheng, Frank O Velez-Cubian, Emily P Ng, Carla C Moodie, Joseph R Garrett, Jacques P Fontaine, Lary A Robinson, Eric M Toloza
BACKGROUND: Lobectomy is standard treatment for early-stage lung cancer, but sublobar resection remains debated. We compared outcomes after robotic-assisted video-assisted thoracoscopic (R-VATS) segmentectomy vs lobectomy. METHODS: We retrospectively analyzed data from 251 consecutive patients who underwent R-VATS lobectomy (n = 208) or segmentectomy (n = 43) by a single surgeon over 36 months. Pulmonary function tests and perioperative outcomes were compared using Chi-squared test, unpaired Student t test, or Kruskal-Wallis test, with significance at P ≤ ...
September 29, 2016: American Journal of Surgery
Ryu Kanzaki, Toru Kimura, Tomohiro Kawamura, Soichiro Funaki, Yasushi Shintani, Masato Minami, Meinoshin Okumura
PURPOSE: To investigate the surgical outcomes of surgery for non-small cell lung cancer (NSCLC) in patients with atrial fibrillation (AF) as a preoperative comorbidity. METHODS: Among 805 patients who underwent surgery for NSCLC, 27 (3.4%) had a history of AF. We analyzed the perioperative and long-term outcomes of these 27 patients. RESULTS: Fourteen patients (52%) had chronic AF and 13 (48%) had paroxysmal AF; being high rates of a comorbid illness...
November 1, 2016: Surgery Today
Alex Herskovic, Elizabeth Mauer, Paul Christos, Himanshu Nagar
BACKGROUND: The role of postoperative radiotherapy (PORT) in the treatment of pathologic stage IIIA (N2) non-small cell lung cancer (NSCLC) remains controversial. We investigated practice patterns and outcomes for these patients in a prospectively maintained nationwide oncology outcomes database. METHODS: Patients with known histologies of pathologic stage IIIA (N2) NSCLC who underwent surgery with negative margins and received adjuvant multiagent chemotherapy from 2004-2013 were identified from the National Cancer DataBase (NCDB) and stratified by the use of PORT...
October 13, 2016: Journal of Thoracic Oncology
Huan H Sun, Joanna Sesti, Jessica S Donington
Recent advances in the surgical treatment of early stage non-small cell lung cancer (NSCLC) have focused heavily on making procedures less invasive, less radical, and better tolerated. Advances in accuracy and increased utilization of cross-sectional imaging allows for diagnosis of smaller and more indolent tumors and preinvasive lesions. Similar to advanced disease, early-stage treatment is now being tailored to individual patients and their tumors. Sublobar resections are gaining acceptance as an oncologically equivalent approach to lobectomy in well-selected stage I patients...
October 2016: Seminars in Respiratory and Critical Care Medicine
S Bommart, J P Berthet, G Durand, B Ghaye, J L Pujol, C Marty-Ané, H Kovacsik
The major lung resections are the pneumonectomies and lobectomies. The sublobar resections are segmentectomies and wedge resections. These are performed either through open surgery through a thoracotomy or by video-assisted mini-invasive surgery for lobectomies and sublobar resections. Understanding the procedures involved allows the normal postoperative appearances to be interpreted and these normal anatomical changes to be distinguished from potential postoperative complications. Surgery results in a more or less extensive physiological adaptation of the chest cavity depending on the lung volume, which has been resected...
October 2016: Diagnostic and Interventional Imaging
T Shaikh, T M Churilla, C T Murphy, M A Hallman, W J Scott, J E Meyer
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Youngkyu Moon, Sook Whan Sung, Seok Whan Moon, Jae Kil Park
BACKGROUND: Sublobar resection is considered controversial for non-small cell lung cancer (NSCLC) presenting as a solid-predominant nodule. The aim of this study was to identify risk factors related to recurrence in small-sized NSCLC presenting as a solid-predominant nodule. METHODS: We conducted a retrospective chart review of 118 patients who were treated for clinical N0 NSCLC sized ≤2 cm and who underwent sublobar resection with clear resection margins. We assigned them to two groups according to radiologic features: ground glass opacity (GGO)-predominant tumor and solid-predominant tumor...
August 2016: Journal of Thoracic Disease
Brian C Gulack, Chi-Fu Jeffrey Yang, Paul J Speicher, Babatunde A Yerokun, Betty C Tong, Mark W Onaitis, Thomas A D'Amico, David H Harpole, Matthew G Hartwig, Mark F Berry
BACKGROUND: The long-term survival benefit of lobectomy over sublobar resection for early-stage non-small cell lung cancer must be weighed against a potentially increased risk of perioperative mortality. The objective of the current study was to create a risk score to identify patients with favorable short-term outcomes following lobectomy. METHODS: The 2005-2012 American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing a lobectomy or sublobar resection (either segmentectomy or wedge resection) for lung cancer...
December 2016: Annals of Thoracic Surgery
Han-Yu Deng, Yun-Cang Wang, Peng-Zhi Ni, Gang Li, Xiao-Yan Yang, Yi-Dan Lin, Lun-Xu Liu
SummaryWhether stereotactic ablative radiotherapy (SABR) is comparable to surgery in treating stage I non-small-cell lung cancer (NSCLC) is unknown. Therefore, we conducted this meta-analysis to compare the efficacy of SABR with that of surgery in treating stage I NSCLC. A systematic literature search in PubMed, Embase, Cochrane Library databases and Google Scholar as well as the American Society of Clinical Oncology was conducted to identify relevant studies dated through 31 December 2015. Data including 3-year survival rate, overall survival (OS) and 3-year loco-regional control (LRC) rates were extracted and analysed...
September 1, 2016: European Journal of Cardio-thoracic Surgery
Jane Keating, Sunil Singhal
Lung cancer screening has lead to frequent diagnosis of solitary pulmonary nodules, many of which require surgical biopsy for diagnosis and intervention. Subcentimeter and central nodules are particularly difficult to visualize or palpate during surgery, thus nodule localization can be a difficult problem for the thoracic surgeon. Although minimally invasive techniques including transthoracic computed tomography and bronchoscopic-guided biopsy may establish a diagnosis, these methods do not help locate nodules during surgery and can lead to inadequate tissue sampling...
2016: Seminars in Thoracic and Cardiovascular Surgery
Alan D L Sihoe, Peter S Y Yu, Timothy H Kam, S Y Lee, Xuyuan Liu
OBJECTIVE: A bespoke clinical pathway is increasingly often used to expedite patient's recovery after video-assisted thoracoscopic surgery (VATS). The importance and predictors of adherence to a clinical pathway have not been previously investigated. METHODS: A defined clinical pathway was used for the perioperative management of 136 consecutive patients receiving major pulmonary resection surgery. The clinical pathway encompassed multiple aspects of clinical care, including chest drainage, analgesia, mobilization, physiotherapy, investigations, etc...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Andres X Samayoa, Todd A Pezzi, Christopher M Pezzi, E Greer Gay, Megumi Asai, Nandini Kulkarni, Ned Carp, Stephen G Chun, Joe B Putnam
BACKGROUND: The benefit of thoracic lymphadenectomy in the treatment of resectable non-small cell lung cancer (NSCLC) continues to be debated. We hypothesized that the number of lymph nodes (LNs) removed for patients with pathologic node-negative NSCLC would correlate with survival. METHODS: The National Cancer Data Base (NCDB) was queried for resected, node-negative, NSCLC patients treated between 2004 and 2014. Patients were grouped according to the number of LNs removed (1-4, 5-8, 9-12, 13-16, and ≥17)...
August 16, 2016: Annals of Surgical Oncology
Elizabeth A David, David T Cooke, Yingjia Chen, Kieranjeet Nijar, Robert J Canter, Rosemary D Cress
BACKGROUND: The prognostic significance of the number of lymph nodes sampled (NLNS) during resection for non-small cell lung cancer (NSCLC) is unclear. The NLNS is influenced by many factors, and some have argued that it should be a surrogate for quality. We sought to determine the influence of the NLNS on overall survival and cancer-specific survival for surgically resected NSCLC. METHODS: The California Cancer Registry was queried from 2004 to 2011 for cases of stage I to III NSCLC treated with surgical resection, identifying 16,393 patients...
July 25, 2016: Annals of Thoracic Surgery
Makoto Sonobe, Hiroshi Date
Recently, lung cancer patients who cannot undergo lobectomy because of impaired pulmonary function, co-morbidity, and/or advanced age are increasing. And patients whose lung cancer is small in size, peripherally located, and assumed to be N0 disease are also increasing. Therefore, we have a greater opportunity to perform sublobar lung resection for these patients. For sublobar resection, several surgical technologies have been developed. Virtual-assisted lung mapping (VAL-MAP) is bronchoscopic multiple dye-marking technique under support of 3-dimensional virtual images to provide geometric information on the lung surface...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Joanna Sesti, Jessica S Donington
Despite a prospective randomized trial that reported decreased locoregional recurrence for the intentional use of sublobar resection for stage IA non-small cell lung cancer, it continues to be a point of considerable debate. Improved imaging techniques have introduced a large group of smaller and more indolent tumors than what was studied 20 years ago by the Lung Cancer Study Group. Multiple single-institution and population-based analyses suggest that sublobar resections may have equivalent outcomes to lobectomy in well-selected patients with small (<2 cm) resections, and in whom an adequate resection margin can be achieved...
August 2016: Thoracic Surgery Clinics
Subroto Paul, Paul C Lee, Jialin Mao, Abby J Isaacs, Art Sedrakyan
OBJECTIVES:  To compare cancer specific survival after thoracoscopic sublobar lung resection and stereotactic ablative radiotherapy (SABR) for tumors ≤2 cm in size and thoracoscopic resection (sublobar resection or lobectomy) and SABR for tumors ≤5 cm in size. DESIGN:  National population based retrospective cohort study with propensity matched comparative analysis. SETTING:  Surveillance, Epidemiology, and End Results (SEER) registry linked with Medicare database in the United States...
July 8, 2016: BMJ: British Medical Journal
Chenyang Dai, Jianfei Shen, Yijiu Ren, Shengyi Zhong, Hui Zheng, Jiaxi He, Dong Xie, Ke Fei, Wenhua Liang, Gening Jiang, Ping Yang, Rene Horsleben Petersen, Calvin S H Ng, Chia-Chuan Liu, Gaetano Rocco, Alessandro Brunelli, Yaxing Shen, Chang Chen, Jianxing He
PURPOSE: According to the lung cancer staging project, T1a (≤ 2 cm) non-small-cell lung cancer (NSCLC) should be additionally classified into ≤ 1 cm and > 1 to 2 cm groups. This study aimed to investigate the surgical procedure for NSCLC ≤ 1 cm and > 1 to 2 cm. METHODS: We identified 15,760 patients with T1aN0M0 NSCLC after surgery from the Surveillance, Epidemiology, and End Results database. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among patients after lobectomy, segmentectomy, or wedge resection...
September 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jun Wang, Hui Zhao
With advances in medical technology, theproportion of early-stage lung cancerhas been growing. Conforming to the trend of individualized treatment, sublobar resection for early stage lung cancer has been considered more valuable than ever before. Currently, there were still confilictions about the oncological validity of sublobar resection comparing with lobectomy for lung cancer. We reviewed the study status of the following contentious issues: the evidence based medicine, the indications of wedge resection or segmentectomy, the weight of tumor diameter and margin distance, and the choices for the elderly...
June 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Hisashi Iwata
Minimizing the volume of lung resection without diminishing curability has recently become an important issue in primary lung cancer. In this review, we will discuss the current state of the feasibility of sublobar resection and specific issues for a segmentectomy procedure. A previous randomized controlled trial showed that lobectomy must still be considered the standard surgical procedure compared with sublobar resection for T1N0 non-small cell lung cancer with a tumor less than 3 cm in size. Since then, supporting studies for segmentectomy of lung cancer with a tumor less than 2 cm in size were reported...
August 2016: General Thoracic and Cardiovascular Surgery
Nobumasa Takahashi, Noriyoshi Sawabata, Masafumi Kawamura, Takashi Ohtsuka, Hirotoshi Horio, Hirozou Sakaguchi, Mitsuo Nakayama, Katsuo Yoshiya, Masayuki Chida, Eishin Hoshi
BACKGROUND: Local therapy for stage I non-small cell lung cancer (NSCLC) is divided into surgical and radiation treatment, and given to patients unable to tolerate a lobectomy. A prospective phase II study of cases that received stereotactic body radio therapy (SBRT) (JCOG0403) revealed an overall 3-year survival rate (3-YSR) of 76.0 %, 3-year relapse free survival rate (3-YRFS) of 69.0 %, and rate of morbidity of grade 3 or greater of 9 %. However, few prospective multicenter studies have reported regarding surgery for high-risk stage I NSCLC patients...
August 2016: General Thoracic and Cardiovascular Surgery
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