The Value of Limited Resection for “Clinical” Stage I Peripheral Non-Small Cell Lung Cancer in Poor-Risk Patients: Comparison of Limited Resection and Lobectomy by a Computer-Assisted Matched Study

Abstract

Aim

A computer-assisted retrospective matched study was devised to compare limited resection and lobectomy for non-small cell lung cancer.

Methods

Of 353 patients undergoing operation for “clinical” stage I peripheral non-small cell lung cancer, 16 patients undergoing limited resection (because of poor risk) could be matched satisfactorily with 16 patients undergoing lobectomy (as a standard procedure) on the basis of age, sex, histology, tumor location, and tumor size with computer assistance.

Results

No hospital death was observed in the 32 patients. Three of the 16 limited resection patients (19%) developed local recurrence in the same lobe. The 5-year survival rate was 55.5% for limited resection and 73.7% for lobectomy (P = not significant). For tumors more than 2.0 cm in diameter, 3-year survival rate was significantly lower in the limited resection group than in the lobectomy group: 34.3% versus 85.7%, P < 0.05. For adenocarcinoma, limited resection seemed to be more unfavorable than lobectomy: 5-year survival rate, 34.3% versus 75.0%, P = 0.07.

Conclusions

Limited resection offered a good survival rate without hospital death for poor-risk patients; however, lobectomy should be performed for good-risk patients.