scholarly journals Current status of surgery for clinical stage IA lung cancer in Japan: analysis of the national clinical database

Surgery Today ◽  
2020 ◽  
Vol 50 (12) ◽  
pp. 1644-1651
Author(s):  
Norihiko Ikeda ◽  
Shunsuke Endo ◽  
Eriko Fukuchi ◽  
Jun Nakajima ◽  
Kohei Yokoi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Postoperative Mortality ◽  
Current Status ◽  
Clinical Database ◽  
National Clinical Database ◽  
Invasive Approach ◽  
Clinical Stage Ia ◽  
Stage Ia

Abstract Purpose As the number of cases of early lung cancer in Japan grows, an analysis of the present status of surgical treatments for clinical stage IA lung cancer using a nationwide database with web-based data entry is warranted. Methods The operative and perioperative data from 47,921 patients who underwent surgery for clinical stage IA lung cancer in 2014 and 2015 were obtained from the National Clinical Database (NCD) of Japan. Clinicopathological characteristics, surgical procedure, mortality, and morbidity were analyzed, and thoracotomy and video-assisted thoracic surgery (VATS) were compared. Results The patients comprised 27,208 men (56.8%) and 20,713 women (43.2%); mean age, 69.3 years. Lobectomy was performed in 64.8%, segmentectomy in 15.2%, and wedge resection in 19.8%. The surgical procedures were thoracotomy in 12,194 patients (25.4%) and a minimally invasive approach (MIA) in 35,727 patients (74.6%). MIA was divided into VATS + mini-thoracotomy (n = 13,422, 28.0%) and complete VATS (n = 22,305, 46.5%). The overall postoperative mortality rate was 0.4%, being significantly lower in the MIA group than in the thoracotomy group (0.3% vs 0.8%, P < 0.001). Conclusions Our analysis of data from the NCD indicates that MIA has become the new standard treatment for clinical stage IA lung cancer.

scholarly journals A multi-institutional randomized phase III trial comparing anatomical segmentectomy and wedge resection for clinical stage IA non-small cell lung cancer in high-risk operable patients: Japan Clinical Oncology Group Study JCOG1909 (ANSWER study)

2020 ◽  
Vol 50 (10) ◽  
pp. 1209-1213 ◽  
Author(s):  
Ryo Shimoyama ◽  
Yasuhiro Tsutani ◽  
Masashi Wakabayashi ◽  
Hiroshi Katayama ◽  
Haruhiko Fukuda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Clinical Stage Ia ◽  
Stage Ia

Abstract Anatomical segmentectomy or wedge resection is recommended for high-risk operable patients with clinical stage IA non-small cell lung cancer in guidelines of the National Comprehensive Cancer Network and the Japanese Lung Cancer Society. However, there is no clear evidence comparing the sublobar resections. The less invasive and more generally performed is wedge resection but anatomical segmentectomy may have better survival benefits than wedge resection owing to its superiority in locoregional control. In April 2020, we have initiated a randomized phase III trial in Japan to confirm the superiority of anatomical segmentectomy over wedge resection in high-risk operable patients with clinical stage IA non-small cell lung cancer. We plan to enroll a total of 370 patients from 47 institutions over a period of 5 years. The primary endpoint is overall survival; the secondary endpoints are adverse events, postoperative respiratory function, relapse-free survival, proportion of local recurrence, operative time and blood loss.

scholarly journals F-147THE IMPORTANCE OF LYMPH NODE DISSECTION ACCOMPANYING WEDGE RESECTION FOR CLINICAL STAGE IA LUNG CANCER

2016 ◽  
Vol 23 (suppl 1) ◽  
pp. i40.2-i40
Author(s):  
Brendon Stiles ◽  
M. Kamel ◽  
A. Nasar ◽  
A. Nguyen ◽  
P. Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Node Dissection ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals The importance of lymph node dissection accompanying wedge resection for clinical stage IA lung cancer†

2016 ◽  
pp. ezw343 ◽  
Author(s):  
Brendon M. Stiles ◽  
Mohamed K. Kamel ◽  
Abu Nasar ◽  
Sebron Harrison ◽  
Andrew B. Nguyen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Node Dissection ◽  
Clinical Stage Ia ◽  
Stage Ia

The prognostic impact of combined pulmonary fibrosis and emphysema in patients with clinical stage IA non-small cell lung cancer

Surgery Today ◽  
2017 ◽  
Vol 48 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Tomoyoshi Takenaka ◽  
Kiyomi Furuya ◽  
Koji Yamazaki ◽  
Naoko Miura ◽  
Kana Tsutsui ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Fibrosis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Stage ◽  
Small Cell ◽  
Prognostic Impact ◽  
Small Cell Lung ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Computed Tomography Histogram Approach to Predict Lymph Node Metastasis in Patients With Clinical Stage IA Lung Cancer

2019 ◽  
Vol 108 (4) ◽  
pp. 1021-1028
Author(s):  
Yoshihisa Shimada ◽  
Yujin Kudo ◽  
Hideyuki Furumoto ◽  
Kentaro Imai ◽  
Sachio Maehara ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Stage ◽  
Node Metastasis ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Complex segmentectomy in the treatment of stage IA non-small-cell lung cancer

2019 ◽  
Vol 57 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Yoshinori Handa ◽  
Yasuhiro Tsutani ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
Morihito Okada
Keyword(s):  
Lung Cancer ◽  
Regression Analysis ◽  
Cancer Treatment ◽  
Cox Regression ◽  
Clinical Stage ◽  
Cancer Control ◽  
Cox Regression Analysis ◽  
Lung Cancer Treatment ◽  
Clinical Stage Ia ◽  
Stage Ia

AbstractOBJECTIVESAlthough segmentectomy for lung cancer has been widely accepted, complex segmentectomy, which creates several, intricate intersegmental planes, remains controversial. Potential arguments include risk of incurability and ‘failure of cancer control’. We compared the outcomes of complex segmentectomy versus lobectomy and evaluated its use in lung cancer treatment.METHODSWe retrospectively reviewed clinical stage IA lung cancer patients who underwent complex segmentectomy (n = 99) or location-adjusted lobectomy (n = 94) between April 2009 and December 2017. Clinicopathological and postoperative results were compared. Factors affecting survival were assessed by the Kaplan–Meier method and the Cox regression analysis.RESULTSNo significant differences were detected in 30-day mortality (0% vs 0%), overall complications (26.3% vs 21.3%) and prolonged air leakage (11.1% vs 9.6%) rates between the 2 groups, respectively. Comparable results were obtained for 5-year overall (93.5% vs 96.4%, respectively; P = 0.21) or recurrence-free (92.3% vs 88.5%, respectively; P = 0.82) survivals after complex segmentectomy or lobectomy. There were 2 (2.0%) recurrences after complex segmentectomy and 7 (7.5%) after lobectomy (P = 0.094), with 0 (0%) margin relapses in each group. Multivariable Cox regression analysis revealed that complex segmentectomy and lobectomy had a numerically similar impact on recurrence-free survival (hazard ratio 0.93, 95% confidence interval 0.32–2.69; P = 0.90).CONCLUSIONSComplex segmentectomy can provide acceptable short- and long-term outcomes in lung cancer treatment.

scholarly journals Assessment of non‐lobe‐specific lymph node metastasis in clinical stage IA non‐small cell lung cancer

2019 ◽  
Vol 10 (7) ◽  
pp. 1597-1604 ◽  
Author(s):  
Zhirong Zhang ◽  
Jinbai Miao ◽  
Qirui Chen ◽  
Yili Fu ◽  
Hui Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell Lung Cancer ◽  
Clinical Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastasis ◽  
Clinical Stage Ia ◽  
Stage Ia
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