The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 6 , Pages 1318-1325.e1 , December 2009

Anatomic segmentectomy for stage I non–small-cell lung cancer: Comparison of video-assisted thoracic surgery versus open approach

  • Matthew J. Schuchert, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
    • Corresponding Author InformationAddress for reprints: Matthew J. Schuchert, MD, Heart, Lung and Esophageal Surgery Institute, Shadyside Medical Building–Suite 715, 5200 Centre Avenue, Pittsburgh, PA 15232.
  • ,
  • Brian L. Pettiford, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • Arjun Pennathur, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • Ghulam Abbas, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • Omar Awais, DO

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • John Close, MA

      Affiliations

    • Department of Dental Public Health and Statistics, University of Pittsburgh, Pittsburgh, Pa
  • ,
  • Arman Kilic, BS

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • Robert Jack

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • James R. Landreneau

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • Joshua P. Landreneau

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • David O. Wilson, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • James D. Luketich, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa
  • ,
  • Rodney J. Landreneau, MD

      Affiliations

    • Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pa

Received 5 May 2008 ,Revised 21 July 2009 ,Accepted 17 August 2009.

References 

  1. Lewis RJ, Caccavale RJ, Sisler GE, Mackenzie JW. Video-assisted thoracic surgical resection of malignant lung tumors. J Thorac Cardiovasc Surg. 1992;104:1679–1685
  2. Shaw JP, Dembitzer FR, Wisnivesky JP, Litle VR, Weiser TS, Yun J, et al. Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac Surg. 2008;85:S705–S709
  3. Landreneau RJ, Hazelrigg SR, Mack MJ, Dowling RD, Gavlick BD, Perrino MK, et al. Post-operative pain-related morbidity: video-assisted thoracic surgery vs. thoracotomy. Ann Thorac Surg. 1993;56:1285–1289
  4. Alam N, Flores RM. Video-assisted thoracic surgery (VATS) lobectomy: the evidence base. J Soc Laparoendoscopic Surgeons. 2007;11:368–374
  5. Cattaneo SM, Park BJ, Wilton AS, Seshan VE, Bains MS, Downey RJ, et al Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008;85:231–235
  6. Whitson BA, Andrade RS, Boettcher A, Bardales R, Kratzke RA, Dahlberg PS, et al. Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage 1 non-small cell lung cancer. Ann Thorac Surg. 2007;83:1965–1970
  7. Demmy TL, Plante AJ, Nwogu CE, Takita H, Anderson TM. Discharge independence with minimally-invasive lobectomy. Am J Surg. 2004;188:698–702
  8. Onaitis NW, Peterson RP, Balderson SS, Toloza E, Burfeind WR, Harpole DH, et al. Thoracoscopic lobectomy is a safe and versatile procedure: experience with 500 consecutive patients. Ann Surg. 2006;244:420–425
  9. McKenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg. 2006;81:421–426
  10. Mountain CF. Revisions in the international system for staging lung cancer. Chest. 1997;111:1710–1717
  11. Schuchert MJ, Pettiford BL, Keeley S, D'Amato TA, Kilic A, Close J, et al. Anatomic segmentectomy in the treatment of stage 1 non-small cell lung cancer. Ann Thorac Surg. 2007;84:926–932
  12. Pettiford BL, Schuchert MJ, Santos R, Landreneau RJ. Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer. Thorac Surg Clin. 2007;17:175–190
  13. Okada M, Yoshikawa K, Hatta T, Tsubota N. Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller?. Ann Thorac Surg. 2001;71:956–961
  14. Ginsberg RJ, Rubenstein LV. Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer. Ann Thorac Surg. 1995;60:615–623
  15. Landreneau RJ, Sugarbaker DJ, Mack MJ, Hazelrigg SR, Luketich JD, Fetterman L, et al. Wedge resection versus lobectomy for stage 1 (T1N0M0) non-small cell lung cancer. J Thorac Cardiovasc Surg. 1997;113:691–700
  16. Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg. 2006;132:769–775
  17. Churchill ED, Belsey R. Segmental pneumonectomy in bronchiectasis. Ann Surg. 1939;109:481–499
  18. Overholt RH, Langer L. A new technique for pulmonary segmental resection, its application in the treatment of bronchiectasis. Surg Gynecol Obstet. 1947;84:3257
  19. Bonfils-Roberts EA, Claggett OT. Contemporary indication for pulmonary segmental resections. J Thorac Surg. 1972;63:433–438
  20. Jensik RJ, Faber LP, Milloy FJ, Monson DO. Segmental resection for lung cancer—a fifteen year experience. J Thorac Cardiovasc Surg. 1973;66:563–572
  21. Read RC, Yoder G, Schaeffer RC. Survival after conservative resection for TIN0M0 non-small cell lung cancer. Ann Thorac Surg. 1990;49:242–247
  22. Warren WH, Faber LP. Segmentectomy versus lobectomy in patients with stage I pulmonary carcinoma. Five-year survival and patterns of intrathoracic recurrence. J Thorac Cardiovasc Surg. 1994;107:1087–1093
  23. Henschke CI, Investigators I-ELCAP. CT screening for lung cancer: update. Surg Oncol Clin N Am. 2005;14:761–776
  24. Tang AW, Moss HA, Robertson RJ. The solitary pulmonary nodule. Eur J Radiol. 2003;45:66–77
  25. Ginsberg RJ, Hill LD, Eagen RT, et al. Modern thirty day operative mortality for surgical resections in lung cancer. J Thorac Cardiovasc Surg. 1983;86:654–658
  26. Wada H, Nakamura T, Nakamoto K, Maeda M, Watanabe Y. Thirty day operative mortality for thoracotomy in lung cancer. J Thorac Cardiovasc Surg. 1998;115:70–73
  27. Keenan RJ, Landreneau RJ, Maley RH, et al. Segmental resection spares pulmonary function in patients with stage I lung cancer. Ann Thorac Surg. 2004;78:228–233
  28. Harada H, Okada M, Sakamoto T, Matsuoka H, Tsubota N. Functional advantage after radical segmentectomy versus lobectomy for lung cancer. Ann Thorac Surg. 2005;80:2041–2045
  29. Okada M, Sakamoto T, Nishio W, et al. Characteristics and prognosis of patients after resection of non-small cell lung carcinoma measuring 2 cm or less in greatest dimension. Cancer. 2003;988:535–541
  30. Kondo D, Yamada K, Kitayama Y, Hoshi S. Peripheral lung adenocarcinomas: 10 mm or less in diameter. Ann Thorac Surg. 2003;76:350–355
  31. Iwasaki A, Hamanaka W, Hamada T, Hiratsuka M, Yamamoto S, Shiraishi T, et al. Comparison between a case-matched analysis of left upper lobe trisegmentectomy and left upper lobectomy for small size lung cancer located in the upper division. Thorac Cardiovasc Surg. 2007;55:454–457
  32. Fernando HC, Santos R, Benfield JR, et al. Lobar and sublobar resection with and without brachytherapy for small stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2005;129:261–267
  33. El-Sherif A, Gooding WE, Santos R, et al. Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surg. 2006;82:408–416
  34. Martin-Ucar AE, Nakas A, Pilling JE, West KJ, Waller DA. A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients. Eur J Cardiothorac Surg. 2005;27:675–679
  35. Sawabata N, Ohta M, Matsumura A, Nagakawa K, Hirano H, Maeda H, et al. Optimal distance of malignant negative margin excision of non-small cell lung cancer: a multicenter prospective study. Ann Thorac Surg. 2004;77:415–420
  36. Roviaro GC, Rebuffat C, Varoli F, Vergani C, Maciocco M, Grignani F, et al. Videoendoscopic thoracic surgery. Int Surg. 1993;78:4–9
  37. Ohtsuka T, Nomori H, Horio H, Naruke T, Suemasu K. Is major pulmonary resection by video-assisted thoracic surgery an adequate procedure in clinical stage I lung cancer?. Chest. 2004;125:1742–1746
  38. Iwasaki A, Shirakusa T, Shiraishi T, Yamamoto S. Results of video-assisted thoracic surgery for stage I/II non-small cell lung cancer. Eur J Cardiothorac Surg. 2004;26:158–164
  39. Houck WV, Fuller CB, McKenna RJ. Video-assisted thoracic surgery upper lobe trisegmentectomy for early stage left apical lung cancer. Ann Thorac Surg. 2004;78:1858–1860
  40. Shiraishi T, Shirakusa T, Iwasaki A, Hiratsuka M, Yamamoto S, Kawahara K. Video-assisted thoracoscopic (VATS) segmentectomy for small peripheral lung cancer tumors. Surg Endosc. 2004;18:1657–1662
  41. Atkins BZ, Harpole DH, Mangum JH, Toloza EM, D'Amico TA, Burfeind WR. Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach. Ann Thorac Surg. 2007;84:1107–1113
  42. Allen MS, Darling GE, Pechet TTV, et al. Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg. 2006;81:1013–1020
  43. Yoshida J, Nagai K, Yokose T, Nishimura M, Kakinuma R, Ohmatsu H, et al. Limited resection trail for pulmonary ground-glass opacity nodules: fifty case experience. J Thorac Cardiovas Surg. 2005;129:991–996

 Disclosures: Supported by Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Pittsburgh, Pennsylvania.

 Presented at The American Association for Thoracic Surgery, 88th Annual Meeting, San Diego, California, May 10 to 14, 2008.

PII: S0022-5223(09)01081-2

doi: 10.1016/j.jtcvs.2009.08.028

The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 6 , Pages 1318-1325.e1 , December 2009