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Can limited pulmonary resection replace lobectomy for small sized lung cancer?
  1. T J Warke
  1. Specialist Registrar, Regional Respiratory Centre, Belfast City Hospital, Belfast, UK, tim{at}dsl.pipex.com

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In this study, patients with stage 1a peripheral non-small cell lung cancer (⩽2 cm maximum diameter) underwent either standard lobectomy (n=159) or limited resection (segmentectomy or wedge resection, n=74). All patients were considered fit for lobectomy and limited resection was performed if the patient consented. There were no significant differences in the 3 or 5 year survival rates between the limited resection group (3 year 94%; 5 year 89%) and the lobectomy group (3 year 97%; 5 year 90%), and there was no significant difference in the incidence of disease recurrence between the two groups (limited resection (n=5), lobectomy (n=9)).

This was not a randomised study and the maximum tumour diameter was significantly smaller in the limited resection group. These results are in agreement with those of a number of similar non-randomised trials, but conflict with the findings of the Lung Cancer Study Group (

). In the latter study, 247 patients were randomised to either limited resection or lobectomy and postoperative mortality and disease recurrence rates were higher in the limited resection group. Lobectomy remains the surgical procedure of choice for patients with peripheral T1N0 non-small cell lung cancer.

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