Expert Point of View: Hisashi Saji, MD
Abstract discussant Hisashi Saji, MD, Chair of Thoracic Surgery at St. Marianna University School of Medicine, Kawasaki, Japan, said that, based on two recently reported phase III studies, sublobar resection, including wedge resection and segmentectomy, must be considered as a standard of care for small-sized, peripheral non–small cell lung cancer without lymph node metastasis. In addition to the possibility of improved overall survival, Dr. Saji also speculated that sublobar resection may reserve “the possibility of more extensive treatment for upcoming life-threatening diseases, such as second primary cancer, respiratory disease, or cerebrovascular disease, after curing lung cancer.”
Hisashi Saji, MD
Although pulmonary function was not shown to significantly differ between patients undergoing sublobar and lobar resection, Dr. Saji also suggested the tests may have been “limited in showing what is less.”
Dr. Saji and colleagues are planning to conduct a meta-analysis to reveal more details such as wedge vs segmentectomy, nodal factor, ground glass–opacities status, histology, and second cancers.
DISCLOSURE: Dr. Saji disclosed financial relationships with Teijin, Chugai Pharm, Taiho, Boehringer Ingelheim, Lilly, Ethicon, Covidien, MSD, Astellas Pharma, Fujifilm Medical, Bristol Myers Squibb, Takeda, Japan Blood Products Organization, Yakult, and Novartis.
After a nearly 20-year wait, the results are finally in: sublobar surgery has been found to be noninferior to lobectomy and may be the new standard of care of patients with small, early-stage non–small cell lung cancer (NSCLC). Results of the phase III Alliance trial, presented at the International ...