[Surgical treatment of early stage non-small cell lung cancer by thoracoscopic segmental resection].

Seguin-Givelet, A; Lutz, Jon Andri; Brian, E; Grigoroiu, M; Gossot, D (2018). [Surgical treatment of early stage non-small cell lung cancer by thoracoscopic segmental resection]. Revue des maladies respiratoires, 35(5), pp. 521-530. Elsevier 10.1016/j.rmr.2018.02.004

Full text not available from this repository.

The rate of segmental resection for early stage non-small cell lung carcinoma (NSCLC) is increasing. However, the indications remain controversial. The aim of this study is to analyze the preliminary results of thoracoscopic segmental resection in early stage NSCLC in terms of morbidity, oncological validity and survival. We report the preliminary results of a consecutive series of 226 thoracoscopic segmentectomies for suspicion of early stage NSCLC.

PATIENTS AND METHODS

Between 2007 and 2016, we performed 322 thoracoscopic anatomical sublobar resections (ASLR). Two hundred and twenty six of these were for suspicion of early stage NSCLC in 222 patients. Data were recorded prospectively and analysed retrospectively on an intent-to-treat basis. Overall and disease-free survivals were estimated on a Kaplan-Meier curve and differences were calculated by a log-rank test.

RESULTS

Twenty-two patients were upstaged (10.4%), in 10 cases to T3 or T4, in 6 cases to N1 and in 6 others to N2 for metastasis. Out of the 6 N1 cases, 3 were discovered at frozen section and resulted in a switch from segmentectomy to lobectomy. There were 10 conversions to thoracotomy (3.9%). Seventeen patients had a more extensive resection than initially planned (7.5%), most often for oncological reasons: invasion of intersegmental lymph nodes (n=3) or insufficient resection margin at frozen section (n=7). Morbidity and mortality were 25.7% and 1.3 % respectively. For pT1aN0 carcinomas, overall and disease-free survivals were 87.1% and 80.6%, respectively. For pT1bN0 carcinomas, overall and disease-free survivals were 88.8 %, and 75.3% respectively.

CONCLUSION

For early stage NSCLC, thoracoscopic ASLR allows reduced perioperative morbidity while offering satisfactory survival. However, a rigorous technique must be applied to reduce the rates of conversion to thoracotomy and extension to lobectomy when required for oncological reasons.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
UniBE Contributor:	Lutz, Jon Andri
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0761-8425
Publisher:	Elsevier
Language:	French
Submitter:	Thomas Michael Marti
Date Deposited:	30 Jan 2019 13:00
Last Modified:	05 Dec 2022 15:25
Publisher DOI:	10.1016/j.rmr.2018.02.004
PubMed ID:	29778621
Uncontrolled Keywords:	Bronchial carcinoma Cancer bronchique Curage ganglionnaire Lymph node dissection Pulmonary segmentectomy Segmentectomie pulmonaire Thoracoscopie Thoracoscopy
URI:	https://boris.unibe.ch/id/eprint/125058