[Use of minimally invasive approaches for stage I non-small cell lung cancer: A surgeon's point of view].
Lobectomy with lymphadenectomy is the standard of care of patients with early stage non-small cell lung cancer, and the use of minimally invasive approaches is associated with reduced morbidity when compared with thoracotomy. Segmentectomy with lymphadenectomy seems to provide a curative effect equivalent to that of lobectomy for stage IA tumours of 2 cm or smaller, and for pure or predominant ground glass opacities. The combination of lung-sparing resections with minimally invasive approaches results in preserved pulmonary function, improved quality of life and very low morbidity. This benefit persists in so-called high-risk patients. Among patients with clinical stage IA managed with sublobar resections, more than 25% are proved to have a more advanced pathologic stage at surgery, suggesting that alternative ablative therapies would result in an incomplete resection in a similar proportion. Moreover, resection samples tumour tissue that is adequate in quantity and quality, and provides material for "research biopsies" to consolidate tissue availability for clinical trials, translational research, and in biobanks.
Service de chirurgie thoracique, Aix-Marseille université, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille, France. Electronic address: pathomas@ap-hm.fr.
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Thomas
D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D013903:Thoracic Surgery
Cancers pulmonaires non à petites cellules; Chirurgie; Chirurgie robot-assistée; Chirurgie vidéothoracoscopique; NSCLC; RATS; Résection infralobaire; Sublobar resections; Surgery; VATS