Limited resection for patients with cT1N0M0 NSCLC not able to tolerate a lobectomy

概要

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At present, lobectomy is the standard surgery for patients with resectable non-small cell lung cancer (NSCLC). However, for high-risk patients, limited resection may be an alternative option. The objective of this study was to evaluate limited resection for high-risk patients and to compare segmentectomy with wedge resection.From 1992 to 2004 (median follow-up of more than 5 years), we treated 102 patients with cT1N0M0 NSCLC who were not able to tolerate a lobectomy with limited resection (segmentectomy: 49, wedge resection: 53). Neither the 5-year overall survival nor disease-free survival (DFS) differed significantly between the segmentectomy group (5-year survival: 79.6%, DFS: 70.3%) and wedge resection group (5-year survival: 69.8%, DFS: 72.5%). The difference in the incidence of postoperative tumor recurrence was not significant. Limited resection should be considered as an alternative for stage IA NSCLCs in high-risk patients. Then, if it is anatomically possible, wedge resection may be a promising procedure.