Nobumasa Takahashi1, Noriyoshi Sawabata2,3, Masafumi Kawamura4, Takashi Ohtsuka5, Hirotoshi Horio6, Hirozou Sakaguchi7, Mitsuo Nakayama8, Katsuo Yoshiya9, Masayuki Chida10, Eishin Hoshi1. 1. General Thoracic Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya, Saitama, Japan. 2. Division of General Thoracic Surgery, Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO), Hirakata, Osaka, 578-5811, Japan. nsawabata@hotmail.com. 3. Division of Health Care, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. nsawabata@hotmail.com. 4. Division of Surgery, Teikyo University School of Medicine, Itabashi, Tokyo, Japan. 5. General Thoracic Surgery, Keio University, Shinjyuku, Tokyo, Japan. 6. General Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyou, Tokyo, Japan. 7. General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan. 8. General Thoracic Surgery, Saitama Medical University Saitama Medical Center, Kawagoe, Saitama, Japan. 9. General Thoracic Surgery, Niigata Cancer Center Hospital, Niigata, Japan. 10. General Thoracic Surgery, Dokkyo Medical University, Tokyo, Japan.
Abstract
BACKGROUND: Local therapy for stage I non-small cell lung cancer (NSCLC) is divided into surgical and radiation treatment, and given to patients unable to tolerate a lobectomy. A prospective phase II study of cases that received stereotactic body radio therapy (SBRT) (JCOG0403) revealed an overall 3-year survival rate (3-YSR) of 76.0 %, 3-year relapse free survival rate (3-YRFS) of 69.0 %, and rate of morbidity of grade 3 or greater of 9 %. However, few prospective multicenter studies have reported regarding surgery for high-risk stage I NSCLC patients. METHODS: We investigated this issue in the setting of a prospective multicenter observational study. Thirty-two high-risk NSCLC patients (30 males, 2 females; median age 74 years, 61-85 years) were analyzed. RESULTS: Two (6.3 %) showed morbidity of grade 3 or greater, though there were no postoperative deaths. The margin local control rate was 97.0 % (surgical margin recurrence, 1) and local recurrence control rate was 75.0 % (ipsilateral thorax recurrence, 8), while the 3-YSR and 3-YRFS was 79.0 and 75.9 %, respectively. CONCLUSION: A sublobar pulmonary resection for patients unable to tolerate a lobectomy with stage I NSCLC was shown to be safe and provided results comparable with those of SBRT.
BACKGROUND: Local therapy for stage I non-small cell lung cancer (NSCLC) is divided into surgical and radiation treatment, and given to patients unable to tolerate a lobectomy. A prospective phase II study of cases that received stereotactic body radio therapy (SBRT) (JCOG0403) revealed an overall 3-year survival rate (3-YSR) of 76.0 %, 3-year relapse free survival rate (3-YRFS) of 69.0 %, and rate of morbidity of grade 3 or greater of 9 %. However, few prospective multicenter studies have reported regarding surgery for high-risk stage I NSCLCpatients. METHODS: We investigated this issue in the setting of a prospective multicenter observational study. Thirty-two high-risk NSCLCpatients (30 males, 2 females; median age 74 years, 61-85 years) were analyzed. RESULTS: Two (6.3 %) showed morbidity of grade 3 or greater, though there were no postoperative deaths. The margin local control rate was 97.0 % (surgical margin recurrence, 1) and local recurrence control rate was 75.0 % (ipsilateral thorax recurrence, 8), while the 3-YSR and 3-YRFS was 79.0 and 75.9 %, respectively. CONCLUSION: A sublobar pulmonary resection for patients unable to tolerate a lobectomy with stage I NSCLC was shown to be safe and provided results comparable with those of SBRT.
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