Limited Resection for Early-Stage Lung Cancer

Abstract

The standard treatment for stage I non-small cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node sampling or dissection. A controversial topic in the surgical management of these patients is the role of limited resection for stage IA lesions, especially those≤2 cm in diameter. The current recommendation for anatomic lobectomy for these patients is based on the results of a single trial in which 267 patients with stage IA cancer (tumors≤3 cm) were randomly assigned to lobectomy or limited resection [1]. This study showed that the lobectomy group had significantly lower locoregional recurrence and a trend toward better survival [1]. Several retrospective studies have suggested that limited resection and lobectomy may lead to similar outcomes among patients with smaller (≤ 2 cm) stage I NSCLC [2, 3]. If sub-lobar resection is proven to be equivalent to lobectomy in terms of survival, limited resections may be preferred as they are associated with better preservation of pulmonary function and reduced morbidity.