Significance of Limited Resection for Small Peripheral Non-small-cell Lung Cancer: Multiinstitutional Prospective Study.:Study Group of Limited Operation for Small Lung Cancer

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• <I><B>Objective</B></I>. The usefulness of extended segmentectomy for small peripheral non-small-cell lung cancer was assessed by comparison with lobectomy. <I><B>Study Design</B>.</I> From 1992 to 1994, 155 patients were enrolled in a multiinstitutional prospective trial for peripheral lung tumors. Fifty-five patients out of 155 were registered in the intended extended segmentectomy group and 100 patients who had preoperative complications were registered in the compromised group. In the extended segmentectomy group, the tumors were 2cm or less in diameter and no metastatic lesion was detected by routine examinations. Twenty patients out of 100 who were enrolled in the compromised group had tumors smaller than 2 cm in diameter and NO disease. They received similar operations as patients in the intended extended segmentectomy group. Fifty-five patients in the intended extended segmentectomy group and 20 patients in the compromised group received extended segmentectomy, and these 75 patients were unified as the extended segmentectomy group. Fifty-five patients who received lobectomy in Sumitomo Hospital and Hyogo Medical Center for periph-eral non-small-cell lung tumors 2cm or less in diameter and no metastatic lesion were compared with the extended segmentectomy group. <I><B>Result</B></I>. There were 17 deaths in the extended segmentectomy group and 7 died due to lung cancer. In these 7 cancer-related deaths, 3 patients died due to lung tumors, 2 died due to distant metastases and 2 died as a result of local recurrence. In the lobectomy group, 19 patients died, 9 due to lung cancer. In these 9 patients, 2 died due to lung tumors, 4 died due to distant metastasis and 3 died due to local recurrence. Five-year survival rates of the extended segmentectomy group and the lobectomy group were 89.5% and 81.3%, respectively, and the difference was not statistically significant between these two groups. Postoperative reduction rates of FVC in the extended segmentectomy group and the lobectomy group were 11.3% and 18.3%, respectively, and the difference was statistically significant (p=0.0046). Postoperative reduction rates of FEV1.0 in the extended segmentectomy group and the lobectomy group were 13.4% and 16.0%, respectively, and no statistically significant difference was recognized (p=0.247). & <I>Conclusion</I>. Extended segmentectomy is a reasonable operation for small peripheral lung cancer.

• 特定非営利活動法人 日本肺癌学会の論文

特定非営利活動法人 日本肺癌学会 | 論文

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