Clinical and Surgical Perspectives in Sublobar Resection for Lung Cancer

Lung cancer, particularly non-small-cell lung cancer (NSCLC), remains a significant health challenge worldwide. Historically, the Lung Cancer Study Group's 1995 randomized controlled trial (RCT) established lobectomy as the standard surgical procedure for clinical stage IA NSCLC due to its superior outcomes in reducing recurrence and cancer-related deaths compared to sublobar resection. However, advancements in imaging technologies, such as computed tomography (CT) and PET-CT, have revolutionized the detection and staging of smaller lung cancers, including those with ground glass opacity. These technological advancements have prompted a reevaluation of the surgical approaches for early-stage NSCLC. Recent high-quality studies, including the Japanese RCT JCOG0802 and CALGB 140503, have compared lobectomy with sublobar resection, suggesting that sublobar resection may not be inferior in terms of overall and relapse-free survival. Despite these findings, variations in trial conditions necessitate further investigation to refine surgical strategies and ensure optimal patient outcomes.

This research topic aims to propose optimal surgical procedures for patients with peripheral small NSCLC that promote better survival without recurrence. By summarizing recent clinical trial results comparing lobectomy and sublobar resection, we will highlight the risks of recurrence and benefits of survival between the two surgical methods. Furthermore, we seek to identify the ideal candidates for sublobar resection, determine whether wedge resection or anatomical segmentectomy is preferable, and establish the optimal surgical margin for wedge resection in cases of small-size NSCLC.

To gather further insights in the clinical and surgical perspectives of sublobar resection for lung cancer, we welcome articles addressing, but not limited to, the following themes:
- Overall survival in patients with peripheral small NSCLC who received sublobar resection versus lobectomy
- Relapse-free survival in patients with peripheral small NSCLC who received sublobar resection versus lobectomy
- Candidate selection for sublobar resection
- Decision-making between wedge resection or segmentectomy in sublobar resection
- Determining the optimal surgical margin in sublobar resection cases

Keywords: Lung cancer, sublobar resection, segmentectomy, wedge resection, survival

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