Less Extensive Surgery Is Just as Effective as Larger Surgery for Some Early Lung Cancers
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NEPTUNE, N.J., March 15, 2023 ~ Investigators from Hackensack Meridian Jersey Shore University Medical Center were part of an international study that showed removing just the part of a lung containing an early-stage lung cancer was as effective as taking out an entire lung lobe, without putting patients at greater risk of a recurrence or poor survival. The findings of the clinical trial, published in the February 9, 2023, issue of the New England Journal of Medicine, could change the standard of care for some people with small cancers in the outer areas of the lung (periphery) that have not spread.

Dr. Thomas Bauer, chairman of surgery at Hackensack Meridian Jersey Shore University Medical Center and one of the study's lead authors, said: "The results of this clinical trial are very important and may change the way we manage early-stage lung cancer. We also witnessed a trend toward better breathing ability in patients who had less lung tissue removed, which could be especially beneficial for people with reduced respiratory function."

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The study randomly assigned 697 patients with peripheral stage 1 non-small cell lung cancer (NSCLC) to undergo either lobectomy (357 patients) or sublobar resection (340 patients). All patients had tumors that were 2 cm or less in size and had not spread to the lymph nodes ("node-negative"). After a median follow-up of 7 years, the rate of recurrence and overall survival were similar between the two groups. Five years later, the rate of recurrence was 64.1% after lobectomy and 63.6% after sublobar resection; 5-year overall survival was 78.9% and 80.3%, respectively.

Patients in the sublobar resection group had forced expiratory volume rates (a measure of lung function) that were 2 percentage points better than those who underwent lobectomy. Forced vital capacity, another measure of breathing ability, was also slightly better for those who underwent sublobar resection.

The authors concluded that sublobar resection is an effective treatment for people with stage 1 node-negative NSCLC and small tumors. They added that these findings will become increasingly relevant as more people are screened for early-stage lung cancer and more older patients with early-stage disease opt for sublobar resection as their preferred surgery option.

For information about thoracic surgery services at Jersey Shore University Medical Center, visit www.hackensackmeridianhealth.org/en/Services/Surgical-Services/Thoracic-Surgery.
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