Table 1.
Selected studies investigating optimal surgical approach in stage I lung cancer.
| Investigators | Year | Study Type | Tumor Size | (n) | Implications |
|---|---|---|---|---|---|
| Altorki et al. | Est. 2024 | Randomized Trial | ≤2 cm | Est. 701 | Active, not yet recruiting trial (accurate 10/2021) NCT00499330 Lobectomy versus sublobar resection for ≤2 cm peripheral lung cancer |
| Chan et al. [27] | 2021 | Retrospective Cohort | 2.1–3.0 cm | 269 | No difference in 5-year OS or recurrence between segmentectomy compared to lobectomy |
| Kamel et al. [5] | 2021 | Retrospective Cohort | 1.5 cm (median) |
254 | Propensity-matched analysis showed no difference in perioperative complications, overall survival, or cancer-specific survival between lobectomy or sublobar resections |
| Li et al. [22] | 2020 | SEER | ≤2 cm | 5474 | Propensity-matched analysis (n = 774) showed equivalence of OS and LCSS between lobectomy and segmentectomy |
| Cao et al. [21] | 2018 | SEER | ≤1 cm | 1913 | No difference in LCSS between lobectomy, segmentectomy, or wedge resection. OS benefit associated with lobectomy |
| 1.1–2.0 cm | 8761 | Similar LCSS associated with lobectomy and segmentectomy, both conferred better LCSS and OS than wedge resection | |||
| 2.1–3.0 cm | 6145 | Lobectomy superior (both OS and LCSS) to wedge resection or segmentectomy. Wedge resection and segmentectomy are similar (OS and LCSS) | |||
| Altorki et al. [3] | 2018 | Randomized Trial | ≤2 cm | 697 | No difference in mortality or morbidity between lobar and sublobar resection Majority of operations performed with MIS (80%), majority of patients ECOG 1 (74%) |
| Kodama et al. [24] | 2016 | Retrospective Cohort | ≤2 cm | 312 | Equivalence in LRFS between lobectomy and segmentectomy, with OS benefit associated in lobectomy in full-cohort analysis. Propensity-matched analysis (n = 138) showed equivalence in OS and LRFS |
| Landreneau et al. [26] | 2014 | Retrospective Cohort | 2.2 cm (mean) |
624 | No significant difference in OS or Recurrence between lobectomy and segmentectomy |
| Altorki et al. [4] | 2014 | Retrospective Cohort | ≤3 cm | 337 | No difference in survival between lobar and sublobar resection. Subgroup analysis of tumor size ≤2 cm showed survival benefit associated with sublobar resection (n = 306) |
| Ginsberg et al. [2] | 1995 | Randomized Trial | ≤3 cm | 247 | No difference in mortality or morbidity between lobar and limited resection. A 75% increase in recurrence rate in limited resection, 30% increase in overall death rate. |
Abbreviations: (n): number of patients included in study, Est.: estimated, OS: overall survival, SEER: Surveillance, Epidemiology, and End Results database, LCSS: lung-cancer-specific survival, ECOG: Eastern Cooperative Oncology Group, LRFS: locoregional recurrence-free survival.