Results of Conservative Surgery for Stage I Lung Cancer

This paper reports our results with sublobar resections for stage I non small cell lung cancer. Sixty-one cases of wedge or segmental resection were compared with 517 standard resections (411 lobectomies and 106 pneumonectomies), performed during the years 1971–88. Operative mortality was 0% in the limited resection group and 4 % (19/517) in the standard resection group; cancer recurrence was detected in 36 % of both groups; actuarial survival at 5 years was 55% versus 48% overall. In 28 patients with pre-existing cardiac or pulmonary co-morbidity, limited resection yielded a similar 5-year survival than standard resection (53 % vs 49 %) with no perioperative deaths (0 vs 6 %). Our data support the experience of other authors on conservative management of stage I lung cancer. Particularly in patients with concomitant cardiopulmonary disease, previous cancer or small peripheral tumors, limited resection combined with adequate nodal staging may be as effective as standard lobar resection with respect to long term survival.