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01-08-2007 | Thoracic Oncology

Margin and Local Recurrence After Sublobar Resection of Non-Small Cell Lung Cancer

Authors: Amgad El-Sherif, MD, Hiran C. Fernando, MD, Ricardo Santos, MD, Brian Pettiford, MD, James D. Luketich, MD, John M. Close, MA, Rodney J. Landreneau, MD

Published in: Annals of Surgical Oncology | Issue 8/2007

Abstract

Background

Local recurrence is a major concern after sublobar resection (SR) of non-small cell lung cancer (NSCLC). We postulate that a large proportion of local recurrence is related to inadequate resection margins. This report analyzes local recurrence after SR of stage I NSCLC. Stratification based on distance of the tumor (<1 cm vs ≥1 cm) to the staple line was performed.

Methods

We reviewed 81 NSCLC patients (44 female) who underwent operation over an 89-month period (January 1997 to June 2004). Mean forced expiratory volume in one second percentiles (FEV1) was 57%. Mean age was 70 (46–86) years. There were 55 wedge and 26 segmental resections. There were 41 tumors with a margin <1 cm and 40 with a margin ≥1 cm. Local recurrence was defined as recurrence within the ipsilateral lung or pulmonary hilum.

Results

There were no perioperative deaths. Mean follow-up was 20 months. Margin distance significantly impacted local recurrence; 6 of 41 patients (14.6%) developed local recurrence in the group with margin less than 1 cm versus 3 of 40 patients (7.5%) in the group with margin equal to or more than 1 cm (P = .04). Of the 41 patients with margins <1 cm, segmentectomy was used in 7 (17%), whereas in the 40 patients with the ≥1 cm margins, segmentectomy was used in 19 (47.5%).

Conclusions

Margin is an important consideration after SR of NSCLC. Wedge resection is frequently associated with margins less than 1 cm and a high risk for locoregional recurrence. Segmentectomy appears to be a better choice of SR when this is chosen as therapy.

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Title: Margin and Local Recurrence After Sublobar Resection of Non-Small Cell Lung Cancer
Authors: Amgad El-Sherif, MD
Hiran C. Fernando, MD
Ricardo Santos, MD
Brian Pettiford, MD
James D. Luketich, MD
John M. Close, MA
Rodney J. Landreneau, MD
Publication date: 01-08-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 8/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9421-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Margin and Local Recurrence After Sublobar Resection of Non-Small Cell Lung Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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