People with early-stage lung cancer need less, study finds

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In a study from Weill Cornell Medicine and elsewhere, scientists found surgery that removes only a portion of one of the five lobes that comprise a lung is as effective as the traditional surgery that removes an entire lobe for certain patients with early-stage lung cancer.

Worldwide, lung cancers are diagnosed in more than two million people, and nearly as many die of the disease, each year.

The vast majority of cases fall into the category known as non-small cell lung cancer (NSCLC), which in its earliest stage—small and localized—is often treated with surgery alone.

An influential 1995 clinical study compared lobectomy to sub-lobar surgery in patients with early-stage lung cancer and found much worse outcomes in the sub-lobar group—triple the rate of tumor recurrence and 50 percent higher mortality.

That established lobectomy as the standard surgical approach for the disease.

However, since the 1990s, major improvements in imaging and determining the stage of cancer have led to increased detection of smaller, early-stage lung tumors, prompting some clinicians to question whether lobectomy is best for such cases.

A trial in early-stage lung cancer patients in Japan found that a sub-lobar technique called segmentectomy had comparable outcomes to standard lobectomy, and even brought a modestly better chance of overall survival.

In the study, the team compared outcomes for nearly 700 patients with early-stage lung cancer.

About half of them were assigned to “lobectomy” surgery, which removes the whole lobe, while the other half had “sublobar resection” surgery, which removes part of the affected lobe.

Over a follow-up period of seven years after surgery, the team found the two groups did not differ strongly in terms of disease-free or overall survival, and the sublobar group had better lung function.

Lobectomy has been the standard approach for early-stage lung cancer surgery for almost 30 years.

But the new results indicate that a subset of early-stage lung cancer patients would be better off, or at least no worse, with the more tissue-conserving sublobar surgery.

The team says the findings suggest that patients don’t always have to have a full lobe of their lungs removed to cure their cancer.

If you care about lung health, please read studies about why Viagra may be useful in treating lung diseases, and scientists find herbal supplements to treat lung cancer.

For more information about health, please see recent studies about gum disease linked to impaired lung function, and results showing  COVID-19 is not just a respiratory illness, it can cause strokes too.

The study was conducted by Dr. Nasser Altorki et al and published in the New England Journal of Medicine.

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