title: Non-small cell lung cancer: when to offer sublobar resection.
abstract: Sublobar resection for lung cancer--whether non-anatomic wedge resection or anatomic segmentectomy--has emerged as a credible alternative to lobectomy for the surgical treatment of selected patients with lung cancer. Sublobar resection promises to cause less pulmonary compromise in such patients. Emerging evidence suggests that sublobar resection may offer survival outcomes approaching that of lobectomy for lung cancer patients whose disease meets the following criteria: stage IA disease only; tumor up to 2-3 cm diameter; peripheral location of tumor in the lung; and predominantly ground-glass (non-solid) appearance on CT imaging. The best results are obtained with segmentectomy (as opposed to wedge resection) and complete lymph node dissection. Nevertheless, the evidence is currently still limited, and the above criteria are met only in a minority of patients. Large randomized trials are underway to define the clinical role of sublobar resections, and results are eagerly anticipated. Until that time, lobectomy should still be regarded as the mainstay of surgical therapy for patients with early stage lung cancer at present.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Alan D L
authors.initials: AD
authors.lastname: Sihoe
authors.affiliation: Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Wilrijkstraat 10, Edegem, B-2650 Antwerp, Belgium. Electronic address: paul.van.schil@uza.be.
authors.forename: Paul
authors.initials: P
authors.lastname: Van Schil
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D012307:Risk Factors; D047368:Tumor Burden
keywords: Lung cancer; Segmentectomy; Sublobar resection; Surgery; Thoracotomy; Video assisted thoracic surgery; Wedge resection