Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message

Recently published large multicenter prospective clinical trials have demonstrated that sublobar resection is noninferior to lobectomy, the traditional treatment of choice, for peripherally located early-stage lung cancer. Most clinical trials and several retrospective studies published to date have...

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Main Authors: Kwon Joong Na, MD, Young Tae Kim, MD, PhD
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:JTCVS Open
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666273623003261
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author Kwon Joong Na, MD
Young Tae Kim, MD, PhD
author_facet Kwon Joong Na, MD
Young Tae Kim, MD, PhD
author_sort Kwon Joong Na, MD
collection DOAJ
description Recently published large multicenter prospective clinical trials have demonstrated that sublobar resection is noninferior to lobectomy, the traditional treatment of choice, for peripherally located early-stage lung cancer. Most clinical trials and several retrospective studies published to date have used the consolidation-to-tumor ratio to define the indication for sublobar resection, as it is well known that the size of the solid portion seen on high-resolution computed tomography is highly correlated with pathologic invasiveness. However, it is difficult to accurately predict pathologic features that may increase the risk of locoregional recurrence, such as specific adenocarcinoma subtypes or spread through air spaces, based on imaging characteristics alone, and the location of the nodule also should be considered one of the important factors in obtaining an adequate parenchymal resection margin. In this article, we summarize the results of the most recently published clinical trials related to sublobar resection and discuss various factors that should be considered for optimal candidate selection for sublobar resection.
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spelling doaj.art-7a7f70110ea2423ab426de7832111e0a2023-12-20T07:38:27ZengElsevierJTCVS Open2666-27362023-12-01161721Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central MessageKwon Joong Na, MD0Young Tae Kim, MD, PhD1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of KoreaAddress for reprints: Young Tae Kim, MD, PhD, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of KoreaRecently published large multicenter prospective clinical trials have demonstrated that sublobar resection is noninferior to lobectomy, the traditional treatment of choice, for peripherally located early-stage lung cancer. Most clinical trials and several retrospective studies published to date have used the consolidation-to-tumor ratio to define the indication for sublobar resection, as it is well known that the size of the solid portion seen on high-resolution computed tomography is highly correlated with pathologic invasiveness. However, it is difficult to accurately predict pathologic features that may increase the risk of locoregional recurrence, such as specific adenocarcinoma subtypes or spread through air spaces, based on imaging characteristics alone, and the location of the nodule also should be considered one of the important factors in obtaining an adequate parenchymal resection margin. In this article, we summarize the results of the most recently published clinical trials related to sublobar resection and discuss various factors that should be considered for optimal candidate selection for sublobar resection.http://www.sciencedirect.com/science/article/pii/S2666273623003261lung cancersublobar resectionlocoregional recurrence
spellingShingle Kwon Joong Na, MD
Young Tae Kim, MD, PhD
Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message
JTCVS Open
lung cancer
sublobar resection
locoregional recurrence
title Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message
title_full Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message
title_fullStr Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message
title_full_unstemmed Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message
title_short Optimal resection strategies for small-size lung cancer: Is a wedge enough? Is lobectomy too much?Central Message
title_sort optimal resection strategies for small size lung cancer is a wedge enough is lobectomy too much central message
topic lung cancer
sublobar resection
locoregional recurrence
url http://www.sciencedirect.com/science/article/pii/S2666273623003261
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