VATS vs. Open Lobectomy for Early Stage Non-Small Cell Lung Cancer

Abstract

Of the estimated 219,440 people in the United States who will be diagnosed with lung cancer in 2009,1 about 13% (32,900 people) will have early stage (American Joint Committee on Cancer [AJCC] stage I and II) non-small cell lung cancer (NSCLC).2,3 Patients with untreated stage I NSCLC, albeit an early stage neoplasm, have a 5-year survival rate of less than 5%.4 – 6 Radiation and chemotherapy (alone or in combination) offer little survival benefit. Only patients who undergo complete surgical resection are afforded a significant chance at long-term survival.7–9 Because early stage tumors are confined within a focus of lung parenchyma, the goal of pulmonary resection for early stage NSCLC is to obtain local control of the tumor, thereby preventing future tumor dissemination. The current standard of care for treating early stage NSCLC patients with sufficient cardiopulmonary reserve is a lobectomy10,11 and complete mediastinal lymph node dissection.12,13