Pulmonary segmentectomy for early stage non-small cell lung cancer: when, for which cases and how

[摘要] Times have changed since lobectomy was considered a curative surgery for lung cancer (1), and segmentectomy is now beginning to be recognized as an alternative surgical procedure for early stage lung cancer. Detailed qualitative diagnosis with thin section helical computed tomography (CT) and improved imaging techniques, such as positron emission tomography (PET), have made it possible to detect smaller lung cancers and at an earlier stage. Attempts at limited surgery and preservation of pulmonary function for these lung cancers are a natural progression. Segmentectomy has been reported to be equivalent in radicality and less invasive compared with lobectomy (2-4). Moreover, the results of a Japanese randomized controlled trial comparing lobectomy with segmentectomy for patients with clinical stage IA non-small cell lung cancer (NSCLC) [tumor diameter ≤2 cm; consolidation-to-tumor (C/T) ratio >0.5] (JCOG0802/WJOG4607L) showed the benefits of segmentectomy versus lobectomy in terms of overall survival (5). Although the indications for segmentectomy are expected to expand, there are still differences between institutions regarding the indications for segmentectomy, including ground-glass opacity (GGO) dominant lesions, and the detailed surgical modalities (intersegmental identification and dissection methods, with or without lymph node dissection, etc.).

[学科分类] 呼吸医学

[关键词] Lung cancer;early stage lung cancer;segmentectomy