Limited resection for Stage I lung cancer

We have reviewed our experience of limited resections for Stage I lung cancer for the years 1971-88. Sixty-one cases of sublobar resection (wedge or segmental) were compared with 411 lobar resections (lobectomies or bilobectomies), performed over the same period. Operative mortality was 0% in the limited resection group and 3% (12/411) in the control group. Cancer recurrence was detected respectively in 36% and 38% of patients, and actuarial survival at 5 years was 55% versus 49% overall. Sublobar resection had a slightly better outcome than lobar resection in pathological T1 (5-year survival of 73% vs 55%) but a worse outcome in pT2 (35% vs 46%); however, none of the differences was statistically significant. In 28 patients with pre-existing cardiac or pulmonary co-morbidity, limited resection yielded the same 5-year survival as lobectomy (53% vs 51%) with no peri-operative deaths (0 vs 5%). Although derived from a retrospective analysis, these data offer a further confirmation that limited resection combined with adequate nodal staging is a reliable and effective technique for early stage lung cancer management.