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J Thorac Cardiovasc Surg 2003;125:924-928
© 2003 The American Association for Thoracic Surgery

General Thoracic Surgery

Intentional limited pulmonary resection for peripheral T1 N0 M0 small-sized lung cancer

Teruaki Koike, MD, Yasushi Yamato, MD, Katsuo Yoshiya, MD, Takehiko Shimoyama, MD, Ryuta Suzuki, MD

From the Division of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan.

Received for publication April 26, 2002. Revisions requested July 8, 2002; revisions received July 22, 2002. Accepted for publication Aug 15, 2002. Address for reprints: Teruaki Koike, MD, Division of Chest Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Niigata, 951-8566 Japan (E-mail koike{at}niigata-cc.niigata.niigata.jp).

Objective: The present study was undertaken to demonstrate that limited pulmonary resection for peripheral small-sized lung cancer yields outcomes not inferior to those of lobectomy.
Methods: During the 9-year period from 1992 to 2000, patients with cT1 N0 M0 peripheral non-small cell lung cancer whose maximum tumor diameter was 2 cm or less on diagnostic imaging and in whom lobectomy was determined to be feasible were treated with limited resection if the patient consented to the procedure and with lobectomy if consent to limited resection was not obtained. The survival and clinical outcome of the patients whose tumors were postoperatively staged as pT1 N0 M0 were compared between the limited resection group (n = 74) and the lobectomy group (n = 159).
Results: The limited resection group consisted of 60 patients treated with segmentectomy and 14 patients treated with wedge resection. Among patients followed up for a mean period of 52 months after the operation, neither the 3-year nor 5-year survivals differed significantly between the limited resection group (3-year survival, 94.0%; 5-year survival, 89.1%) and the lobectomy group (3-year survival, 97.0%; 5-year survival, 90.1%). Postoperative tumor recurrence was noted in 5 patients after limited resection and in 9 patients after lobectomy, and the difference in the incidence of postoperative recurrence between the 2 groups was not significant.
Conclusions: The results of this study indicate that in patients with peripheral T1 N0 M0 non-small cell lung cancer whose maximum tumor diameter was 2 cm or less, the outcome of limited pulmonary resection is comparable with that of pulmonary lobectomy.




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