Résection infra-lobaire dans le CBNPC de stade précoce : vers un nouveau standard thérapeutique ? Critères de qualité et recommandations européennes: Sublobar resection: a new gold standard in early NSCLC?

Abstract

Until now, the gold standard surgical treatment for early-stage non-small-cell lung cancer (NSCLC) has been pulmonary lobectomy with lymph node dissection. However, several cohort studies have suggested that infra-lobar resection may provide equivalent survival while better preserving quality of life and lung function. The results of two prospective randomized phase III studies comparing sublobar resection (segmentectomy or wedge resection) have recently been published. The JCOG 0802 trial focused on cT1a-b NSCLC and showed significantly better survival in the segmentectomy group, but a higher rate of local recurrence. The CALGB 140503 trial involving stage Ia NSCLC showed no difference in survival and recurrence rate between the two groups. Some questions remain unanswered in these studies, particularly in the CALGB 140503 trial where a majority of patients had an atypical resection. Pending clarification, the complexity of this new surgery calls for oncological rigor in terms of indications and technique, as well as compliance with quality criteria.In this article, we present the key quality criteria for subobar resection of NSCLC, based on the results of the two trials mentioned above and on recently published European recommendations.1877-1203/© 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.