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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
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Limited resections in high-risk patients.

Michèle De Waele1, Paul Van Schil

  • 1Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Wilrijkstraat, Edegem, Belgium.

Current Opinion in Pulmonary Medicine
|May 29, 2015
PubMed
Summary

For early-stage nonsmall cell lung cancer (NSCLC), sublobar resection is a viable option for high-risk patients. Further studies are needed to confirm survival benefits compared to other treatments.

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Area of Science:

  • Thoracic Surgery
  • Oncology
  • Radiation Oncology

Background:

  • The optimal treatment for early-stage nonsmall cell lung cancer (NSCLC) in high-risk patients is debated.
  • Limited resection, stereotactic radiotherapy, and radiofrequency ablation are alternative treatments to surgical resection.

Purpose of the Study:

  • To review the role of limited, sublobar resection in early-stage NSCLC patients at high risk for surgical intervention.
  • To discuss current evidence and the need for further research in this patient population.

Main Methods:

  • Literature review of retrospective analyses and ongoing clinical trials.
  • Discussion of treatment options based on current evidence and expert opinion.

Main Results:

  • Definitions of high-risk patients and randomized trials are lacking.
  • Retrospective analyses suggest sublobar resection may be oncologically sound for selected clinical stage IA NSCLC patients.
  • Stereotactic radiotherapy is a viable alternative for patients unfit for surgery.

Conclusions:

  • Surgery is the gold standard for NSCLC; however, multidisciplinary consultation is crucial for high-risk patients.
  • Sublobar anatomical resection is preferred over nonsurgical options for staging and prognosis in early-stage NSCLC.
  • A randomized prospective study is essential to compare survival outcomes for high-risk patients undergoing surgery versus radiation-based treatments.