Sublobar resection for the subcentimeter pulmonary nodule.
Several studies have demonstrated an increased local recurrence rate with sublobar resection (SR) when compared with lobar resection for the treatment of non-small-cell lung cancer (NSCLC). Therefore, lobectomy has remained the gold standard therapy for NSCLC with lesser resection reserved as a compromise operation for high-risk patients. The increased identification of small NSCLC tumors by CT scan is leading many surgeons to question the appropriateness of lobectomy for these tumors. There has been increasing interest by many surgeons to use SR as intentional therapy for patients with small peripheral NSCLC. This article reviews the recent literature and evidence supporting intentional SR for NSCLC. Although lobectomy should continue to be regarded as the procedure of choice for NSCLC, we believe that a subset of patients with favorable characteristics may be appropriately treated with intentional SR as long as good assessment of nodal involvement is made. Future investigation is required to better define when SR is appropriate.
Ketchedjian
Ara
A
Department of Cardiothoracic Surgery, Boston Medical Center, Boston University, Boston, Massachusetts 02118, USA.
Daly
Benedict
B
Landreneau
Rodney
R
Fernando
Hiran
H
D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D001918:Brachytherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D003074:Solitary Pulmonary Nodule / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D019616:Thoracic Surgical Procedures; D014057:Tomography, X-Ray Computed