Results of a limited resection for compromised or poor-risk patients with clinical stage I non-small cell carcinoma of the lung.
BACKGROUND
Patients with stage I non-small cell carcinoma of the lung may be unable to undergo a standard curative resection, such as lobectomy, due to various medical reasons. Whether or not a limited resection is superior to radiotherapy in these patients, both in terms of long-term prognosis and treatment morbidity, is unknown.


METHODS
We retrospectively reviewed our results in treating compromised or poor-risk patients with clinical stage I non-small cell carcinoma of the lung who had received either a limited resection or radiotherapy. Seventeen patients underwent a limited resection (nine wedge resections and eight segmentectomies), while 18 patients received radiation therapy.


RESULTS
The five-year survival rates for patients in the limited resection group and the radiation treatment group were 55.0 and 14.4 percent, respectively. A log-rank analysis showed a significant difference between the two groups (p = 0.004). Furthermore, the survival rate of the patients having a limited operation was significantly better than that of patients achieving either complete response or partial response from radiotherapy (18.8 percent at five years, p = 0.008). Recurrence at the surgical margin occurred in four patients in whom the tumor was greater than 2 cm in longest diameter. The incidence of severe treatment-related complications was not different between the limited operation group and the radiotherapy group (11.8 compared to 11.1 percent).


CONCLUSIONS
The results indicate that a limited resection for patients with poor-risk clinical stage I carcinoma of the lung has an advantage over radiotherapy, especially for tumors measuring less than 2 cm in longest diameter.
Yano
T
T
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Yokoyama
H
H
Yoshino
I
I
Tayama
K
K
Asoh
H
H
Hata
K
K
Ichinose
Y
Y
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome