For Older Patients With Lung Cancer, Limited Resection Not Equivalent to Lobectomy

Limited resection is not equivalent to lobectomy in older patients with invasive non-small cell lung cancer no more than 2 cm in size, a new study published online ahead of print in the Journal of Clinical Oncology has shown; however, segmentectomy may be equivalent in patients with adenocarcinoma histology.

Because the use of limited resection in older patients with stage 1A lung cancer has been increasing, researchers sought to assess the equivalency of limited resection versus lobectomy according to histology.

Researchers identified a total of 3,147 patients older than 65 years with stage 1A invasive adenocarcinoma or squamous cell carcinoma no more than 2 cm who underwent limited resection or lobectomy from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Limited resection included wedge resection and segmentectomy.

Results showed that limited resection was not equivalent to patients with adenocarcinoma (HR = 1.21; upper 95% CI: 1.34) or squamous cell carcinoma (HR = 1.21; upper 95% CI: 1.39); however, researchers found that segmentectomy was equivalent to lobectomy in terms of survival in patients with adenocarcinoma (HR = 0.97; upper 95% CI: 1.07). Wedge resection was not equivalent to lobectomy.

Among patients with squamous cell carcinoma, both wedge resection and segmentectomy were not equivalent to lobectomy.

Reference

1. Veluswamy RR, Ezer N, Mhango G, et al. Limited resection versus lobectomy for older patients with early-stage lung cancer: impact of histology. J Clin Oncol. 2015. [epub ahead of print]. doi: 10.1200/JCO.2014.60.6624.