Controversy over surgical modalities for early non-small cell lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Qiang ^1,2,3 , KONG Hao ^2,3,4,5 , ZHANG Boyou ^1,2,3 , QIAN Banglun ¹ , LU Yi ^2,4,5 , SUN Fei ^2,4,5 ,  SHI Hongcan ^2,3,4,5

1. Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, P. R. China;
2. Key Laboratory of Integrative Medicine in Geriatrics Control of Jiangsu Province, Yangzhou University, Yangzhou, 225009, P. R. China;
3. Northern Jiangsu People’s Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, 225001, P. R. China;
4. Clinical Medical College of Yangzhou University, Yangzhou, 225009, P. R. China;
5. Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China;

Corresponding?author：

SHI Hongcan, Email: shihongcan@yzu.edu.cn

Keywords：

Non-small cell lung cancer; lobectomy; segmetectomy; wedge resection; stereotactic body radiation therapy (SBRT); image-guided thermal ablation (IGTA)

DOI：

10.7507/1007-4848.202105059

Video：

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Lobectomy and systematic nodules resection has been the standard surgical procedure for non-small cell lung cancer (NSCLC). However, increased small-size lung cancer has been identified with the widespread implementation of low-dose computed tomography (LDCT) screening, and it is controversial whether it is proper to choose lobar resection for the pulmonary nodules. Numerous retrospective researches and randomized clinical trials, such as JCOG0201, JCOG0804/WJOG4507L, JCOG0802 and CALGB/Alliance 140503, revealed that the sublobar resection was safe and effective for NSCLC with maximum tumor diameter≤2 cm and with consolidation tumor ratio (CTR)≤0.25, and that segmentectomy was superior to lobectomy with significant differences in 5-year overall survival rate and respiratory function for patients with small-size (≤2 cm, CTR>0.5) NSCLC and should be the standard surgical procedure. It is the principle for multiple primary lung cancer that priority should be given to primary lesions with secondary lesions considered, and it is feasible to handle the multiple lung nodules based on the patients' individual characteristics.

Citation： WU Qiang, KONG Hao, ZHANG Boyou, QIAN Banglun, LU Yi, SUN Fei, SHI Hongcan. Controversy over surgical modalities for early non-small cell lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(8): 1066-1072. doi: 10.7507/1007-4848.202105059 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2.	鄭榮壽, 孫可欣, 張思維, 等. 2015年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2019, 41(1): 19-28.
3.	Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5): 395-409.
4.	NCCN clinical practice guidelines in oncology (NCCN Guidelines®) non-small cell lung cancer (version 4.2021). March 3, 2021. Available from: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf.
5.	Howington JA, Blum MG, Chang AC, et al. Treatment of stage Ⅰ and Ⅱ non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5Suppl): e278S-e313S.
6.	中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2018版). 中華腫瘤雜志, 2018, 40(12): 935-964.
7.	Nakagawa K, Watanabe SI, Kunitoh H, et al. The Lung Cancer Surgical Study Group of the Japan Clinical Oncology Group: Past activities, current status and future direction. Jpn J Clin Oncol, 2017, 47(3): 194-199.
8.	Yang F, Sui X, Chen X, et al. Sublobar resection versus lobectomy in surgical treatment of elderly patients with early-stage non-small cell lung cancer (STEPS): Study protocol for a randomized controlled trial. Trials, 2016, 17: 191.
9.	Altorki NK, Wang X, Wigle D, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: Post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med, 2018, 6(12): 915-924.
10.	李為希, 周潔, 張芬, 等. 低劑量螺旋CT對高危人群的肺癌篩查結果分析. 中國腫瘤, 2019, 28(12): 896-900.
11.	Church TR, Black WC, Aberle DR, et al. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med, 2013, 368(21): 1980-1991.
12.	Lopes Pegna A, Picozzi G, Falaschi F, et al. Four-year results of low-dose CT screening and nodule management in the ITALUNG trial. J Thorac Oncol, 2013, 8(7): 866-875.
13.	He YT, Zhang YC, Shi GF, et al. Risk factors for pulmonary nodules in north China: A prospective cohort study. Lung Cancer, 2018, 120: 122-129.
14.	趙俊松, 崔利, 何江波, 等. 上海22351例無癥狀體檢者低劑量CT肺癌篩查及隨訪結果初步分析. 診斷學理論與實踐, 2019, 18(02): 183-188.
15.	Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003-15: A pooled analysis of 17 population-based cancer registries. Lancet Glob Health, 2018, 6(5): e555-e567.
16.	Yang D, Liu Y, Bai C, et al. Epidemiology of lung cancer and lung cancer screening programs in China and the United States. Cancer Lett, 2020, 468: 82-87.
17.	Huang F, Pan B, Wu J, et al. Relationship between exposure to PM2.5 and lung cancer incidence and mortality: A meta-analysis. Oncotarget, 2017, 8(26): 43322-43331.
18.	Sheng L, Tu JW, Tian JH, et al. A meta-analysis of the relationship between environmental tobacco smoke and lung cancer risk of nonsmoker in China. Medicine (Baltimore), 2018, 97(28): e11389.
19.	Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.
20.	Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: Survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
21.	Katsumata S, Aokage K, Nakasone S, et al. Radiologic criteria in predicting pathologic less invasive lung cancer according to TNM 8th edition. Clin Lung Cancer, 2019, 20(2): e163-e170.
22.	Ito H, Suzuki K, Mizutani T, et al. Long-term survival outcome after lobectomy in patients with clinical T1 N0 lung cancer. J Thorac Cardiovasc Surg, 2020, 161(1): 281-290.
23.	Nomori H, Mori T, Shiraishi A, et al. Long-term prognosis after segmentectomy for cT1N0M0 non-small cell lung cancer. Ann Thorac Surg, 2019, 107(5): 1500-1506.
24.	Subramanian M, McMurry T, Meyers BF, et al. Long-term results for clinical stageⅠA lung cancer: Comparing lobectomy and sublobar resection. Ann Thorac Surg, 2018, 106(2): 375-381.
25.	Dai C, Shen J, Ren Y, et al. Choice of surgical procedure for patients with non-small-cell lung cancer ≤1 cm or >1 to 2 cm among lobectomy, segmentectomy, and wedge resection: A population-based study. J Clin Oncol, 2016, 34(26): 3175-3182.
26.	Su H, Xie H, Dai C, et al. Procedure-specific prognostic impact of micropapillary subtype may guide resection strategy in small-sized lung adenocarcinomas: A multicenter study. Ther Adv Med Oncol, 2020: 121-13.
27.	Chiang XH, Hsu HH, Hsieh MS, et al. Propensity-matched analysis comparing survival after sublobar resection and lobectomy for cT1N0 lung adenocarcinoma. Ann Surg Oncol, 2020, 27(3): 703-715.
28.	Zhang Y, Sun Y, Wang R, et al. Meta-analysis of lobectomy, segmentectomy, and wedge resection for stageⅠ non-small cell lung cancer. J Surg Oncol, 2015, 111(3): 334-340.
29.	Deng HY, Wang YC, Ni PZ, et al. Radiotherapy, lobectomy or sublobar resection? A meta-analysis of the choices for treating stage Ⅰ non-small-cell lung cancer. Eur J Cardiothorac Surg, 2017, 51(2): 203-210.
30.	Rao S, Ye L, Min L, et al. Meta-analysis of segmentectomy versus lobectomy for radiologically pure solid or solid-dominant stage ⅠA non-small cell lung cancer. J Cardiothorac Surg, 2019, 14(1): 197.
31.	Winckelmans T, Decaluwé H, De Leyn P, et al. Segmentectomy or lobectomy for early-stage non-small-cell lung cancer: A systematic review and meta-analysis. Eur J Cardiothorac Surg, 2020, 57(6): 1051-1060.
32.	Cao J, Yuan P, Wang Y, et al. Survival rates after lobectomy, segmentectomy, and wedge resection for non-small cell lung cancer. Ann Thorac Surg, 2018, 105(5): 1483-1491.
33.	Raman V, Jawitz OK, Voigt SL, et al. The effect of tumor size and histologic findings on outcomes after segmentectomy vs. lobectomy for clinically node-negative non-small cell lung cancer. Chest, 2021, 159(1): 390-400.
34.	姜格寧, 陳昶, 朱余明, 等. 上海市肺科醫院磨玻璃結節早期肺腺癌的診療共識(第一版). 中國肺癌雜志, 2018, 21(3): 147-159.
35.	武強, 張博友, 孫飛, 等. 多發性肺結節影像學管理現狀及進展. 中國胸心血管外科臨床雜志, 2021, 28(3): 363-367.
36.	Zheng H, Peng Q, Xie D, et al. Simultaneous bilateral thoracoscopic lobectomy for synchronous bilateral multiple primary lung cancer-single center experience. J Thorac Dis, 2021, 13(3): 1717-1727.
37.	Motono N, Iwai S, Iijima Y, et al. Repeat pulmonary resection for lung malignancies does not affect the postoperative complications: A retrospective study. BMC Pulm Med, 2021, 21(1): 109.
38.	Yang H, Sun Y, Yao F, et al. Surgical therapy for bilateral multiple primary lung cancer. Ann Thorac Surg, 2016, 101(3): 1145-1152.
39.	Huang C, Sun Y, Wu Q, et al. Simultaneous bilateral pulmonary resection via single-utility port VATS for multiple pulmonary nodules: A single-center experience of 16 cases. Thorac Cancer, 2021, 12(4): 525-533.
40.	Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2020, S0022-5223(20): 33043-33049.
41.	Aokage K, Saji H, Suzuki K, et al. A non-randomized confirmatory trial of segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-section computed tomography (JCOG1211). Gen Thorac Cardiovasc Surg, 2017, 65(5): 267-272.
42.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
43.	Asamura H, Okada M, Saji H, et al. Randomized trial of segmentectomy compared to lobectomy in small-sized peripheral non-small cell lung cancer. April 23, 2021. Available from: https://annualmeeting.aats.org/.
44.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
45.	Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615.
46.	Videtic GMM, Donington J, Giuliani M, et al. Stereotactic body radiation therapy for early-stage non-small cell lung cancer: Executive summary of an ASTRO evidence-based guideline. Pract Radiat Oncol, 2017, 7(5): 295-301.
47.	Dupuy DE, Fernando HC, Hillman S, et al. Radiofrequency ablation of stage ⅠA non-small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial. Cancer, 2015, 121(19): 3491-3498.
48.	Baumann P, Nyman J, Hoyer M, et al. Outcome in a prospective phase Ⅱ trial of medically inoperable stage Ⅰ non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol, 2009, 27(20): 3290-3296.
49.	Sun B, Brooks ED, Komaki RU, et al. 7-year follow-up after stereotactic ablative radiotherapy for patients with stage Ⅰ non-small cell lung cancer: Results of a phase 2 clinical trial. Cancer, 2017, 123(16): 3031-3039.
50.	Chang JY, Senan S, Paul MA, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage Ⅰ non-small-cell lung cancer: A pooled analysis of two randomised trials. Lancet Oncol, 2015, 16(6): 630-637.
51.	Lam A, Yoshida EJ, Bui K, et al. A national cancer database analysis of radiofrequency ablation versus stereotactic body radiotherapy in early-stage non-small cell lung cancer. J Vasc Interv Radiol, 2018, 29(9): 1211-1217.
52.	Palussiere J, Lagarde P, Aupérin A, et al. Percutaneous lung thermal ablation of non-surgical clinical N0 non-small cell lung cancer: Results of eight years' experience in 87 patients from two centers. Cardiovasc Intervent Radiol, 2015, 38(1): 160-166.
53.	Akeboshi M, Yamakado K, Nakatsuka A, et al. Percutaneous radiofrequency ablation of lung neoplasms: Initial therapeutic response. J Vasc Interv Radiol, 2004, 15(5): 463-470.
54.	Palussière J, Chomy F, Savina M, et al. Radiofrequency ablation of stageⅠA non-small cell lung cancer in patients ineligible for surgery: Results of a prospective multicenter phaseⅡ trial. J Cardiothorac Surg, 2018, 13(1): 91.
55.	Páez-Carpio A, Gómez FM, Isus Olivé G, et al. Image-guided percutaneous ablation for the treatment of lung malignancies: Current state of the art. Insights Imaging, 2021, 12(1): 57.
56.	Shimoyama R, Tsutani Y, Wakabayashi M, et al. A multi-institutional randomized phaseⅢ trial comparing anatomical segmentectomy and wedge resection for clinical stageⅠA non-small cell lung cancer in high-risk operable patients: Japan Clinical Oncology Group Study JCOG1909 (ANSWER study). Jpn J Clin Oncol, 2020, 50(10): 1209-1213.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2. 鄭榮壽, 孫可欣, 張思維, 等. 2015年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2019, 41(1): 19-28.
3. Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5): 395-409.
4. NCCN clinical practice guidelines in oncology (NCCN Guidelines®) non-small cell lung cancer (version 4.2021). March 3, 2021. Available from: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf.
5. Howington JA, Blum MG, Chang AC, et al. Treatment of stage Ⅰ and Ⅱ non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5Suppl): e278S-e313S.
6. 中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2018版). 中華腫瘤雜志, 2018, 40(12): 935-964.
7. Nakagawa K, Watanabe SI, Kunitoh H, et al. The Lung Cancer Surgical Study Group of the Japan Clinical Oncology Group: Past activities, current status and future direction. Jpn J Clin Oncol, 2017, 47(3): 194-199.
8. Yang F, Sui X, Chen X, et al. Sublobar resection versus lobectomy in surgical treatment of elderly patients with early-stage non-small cell lung cancer (STEPS): Study protocol for a randomized controlled trial. Trials, 2016, 17: 191.
9. Altorki NK, Wang X, Wigle D, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: Post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med, 2018, 6(12): 915-924.
10. 李為希, 周潔, 張芬, 等. 低劑量螺旋CT對高危人群的肺癌篩查結果分析. 中國腫瘤, 2019, 28(12): 896-900.
11. Church TR, Black WC, Aberle DR, et al. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med, 2013, 368(21): 1980-1991.
12. Lopes Pegna A, Picozzi G, Falaschi F, et al. Four-year results of low-dose CT screening and nodule management in the ITALUNG trial. J Thorac Oncol, 2013, 8(7): 866-875.
13. He YT, Zhang YC, Shi GF, et al. Risk factors for pulmonary nodules in north China: A prospective cohort study. Lung Cancer, 2018, 120: 122-129.
14. 趙俊松, 崔利, 何江波, 等. 上海22351例無癥狀體檢者低劑量CT肺癌篩查及隨訪結果初步分析. 診斷學理論與實踐, 2019, 18(02): 183-188.
15. Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003-15: A pooled analysis of 17 population-based cancer registries. Lancet Glob Health, 2018, 6(5): e555-e567.
16. Yang D, Liu Y, Bai C, et al. Epidemiology of lung cancer and lung cancer screening programs in China and the United States. Cancer Lett, 2020, 468: 82-87.
17. Huang F, Pan B, Wu J, et al. Relationship between exposure to PM2.5 and lung cancer incidence and mortality: A meta-analysis. Oncotarget, 2017, 8(26): 43322-43331.
18. Sheng L, Tu JW, Tian JH, et al. A meta-analysis of the relationship between environmental tobacco smoke and lung cancer risk of nonsmoker in China. Medicine (Baltimore), 2018, 97(28): e11389.
19. Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.
20. Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: Survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
21. Katsumata S, Aokage K, Nakasone S, et al. Radiologic criteria in predicting pathologic less invasive lung cancer according to TNM 8th edition. Clin Lung Cancer, 2019, 20(2): e163-e170.
22. Ito H, Suzuki K, Mizutani T, et al. Long-term survival outcome after lobectomy in patients with clinical T1 N0 lung cancer. J Thorac Cardiovasc Surg, 2020, 161(1): 281-290.
23. Nomori H, Mori T, Shiraishi A, et al. Long-term prognosis after segmentectomy for cT1N0M0 non-small cell lung cancer. Ann Thorac Surg, 2019, 107(5): 1500-1506.
24. Subramanian M, McMurry T, Meyers BF, et al. Long-term results for clinical stageⅠA lung cancer: Comparing lobectomy and sublobar resection. Ann Thorac Surg, 2018, 106(2): 375-381.
25. Dai C, Shen J, Ren Y, et al. Choice of surgical procedure for patients with non-small-cell lung cancer ≤1 cm or >1 to 2 cm among lobectomy, segmentectomy, and wedge resection: A population-based study. J Clin Oncol, 2016, 34(26): 3175-3182.
26. Su H, Xie H, Dai C, et al. Procedure-specific prognostic impact of micropapillary subtype may guide resection strategy in small-sized lung adenocarcinomas: A multicenter study. Ther Adv Med Oncol, 2020: 121-13.
27. Chiang XH, Hsu HH, Hsieh MS, et al. Propensity-matched analysis comparing survival after sublobar resection and lobectomy for cT1N0 lung adenocarcinoma. Ann Surg Oncol, 2020, 27(3): 703-715.
28. Zhang Y, Sun Y, Wang R, et al. Meta-analysis of lobectomy, segmentectomy, and wedge resection for stageⅠ non-small cell lung cancer. J Surg Oncol, 2015, 111(3): 334-340.
29. Deng HY, Wang YC, Ni PZ, et al. Radiotherapy, lobectomy or sublobar resection? A meta-analysis of the choices for treating stage Ⅰ non-small-cell lung cancer. Eur J Cardiothorac Surg, 2017, 51(2): 203-210.
30. Rao S, Ye L, Min L, et al. Meta-analysis of segmentectomy versus lobectomy for radiologically pure solid or solid-dominant stage ⅠA non-small cell lung cancer. J Cardiothorac Surg, 2019, 14(1): 197.
31. Winckelmans T, Decaluwé H, De Leyn P, et al. Segmentectomy or lobectomy for early-stage non-small-cell lung cancer: A systematic review and meta-analysis. Eur J Cardiothorac Surg, 2020, 57(6): 1051-1060.
32. Cao J, Yuan P, Wang Y, et al. Survival rates after lobectomy, segmentectomy, and wedge resection for non-small cell lung cancer. Ann Thorac Surg, 2018, 105(5): 1483-1491.
33. Raman V, Jawitz OK, Voigt SL, et al. The effect of tumor size and histologic findings on outcomes after segmentectomy vs. lobectomy for clinically node-negative non-small cell lung cancer. Chest, 2021, 159(1): 390-400.
34. 姜格寧, 陳昶, 朱余明, 等. 上海市肺科醫院磨玻璃結節早期肺腺癌的診療共識(第一版). 中國肺癌雜志, 2018, 21(3): 147-159.
35. 武強, 張博友, 孫飛, 等. 多發性肺結節影像學管理現狀及進展. 中國胸心血管外科臨床雜志, 2021, 28(3): 363-367.
36. Zheng H, Peng Q, Xie D, et al. Simultaneous bilateral thoracoscopic lobectomy for synchronous bilateral multiple primary lung cancer-single center experience. J Thorac Dis, 2021, 13(3): 1717-1727.
37. Motono N, Iwai S, Iijima Y, et al. Repeat pulmonary resection for lung malignancies does not affect the postoperative complications: A retrospective study. BMC Pulm Med, 2021, 21(1): 109.
38. Yang H, Sun Y, Yao F, et al. Surgical therapy for bilateral multiple primary lung cancer. Ann Thorac Surg, 2016, 101(3): 1145-1152.
39. Huang C, Sun Y, Wu Q, et al. Simultaneous bilateral pulmonary resection via single-utility port VATS for multiple pulmonary nodules: A single-center experience of 16 cases. Thorac Cancer, 2021, 12(4): 525-533.
40. Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2020, S0022-5223(20): 33043-33049.
41. Aokage K, Saji H, Suzuki K, et al. A non-randomized confirmatory trial of segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-section computed tomography (JCOG1211). Gen Thorac Cardiovasc Surg, 2017, 65(5): 267-272.
42. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
43. Asamura H, Okada M, Saji H, et al. Randomized trial of segmentectomy compared to lobectomy in small-sized peripheral non-small cell lung cancer. April 23, 2021. Available from: https://annualmeeting.aats.org/.
44. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
45. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615.
46. Videtic GMM, Donington J, Giuliani M, et al. Stereotactic body radiation therapy for early-stage non-small cell lung cancer: Executive summary of an ASTRO evidence-based guideline. Pract Radiat Oncol, 2017, 7(5): 295-301.
47. Dupuy DE, Fernando HC, Hillman S, et al. Radiofrequency ablation of stage ⅠA non-small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial. Cancer, 2015, 121(19): 3491-3498.
48. Baumann P, Nyman J, Hoyer M, et al. Outcome in a prospective phase Ⅱ trial of medically inoperable stage Ⅰ non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol, 2009, 27(20): 3290-3296.
49. Sun B, Brooks ED, Komaki RU, et al. 7-year follow-up after stereotactic ablative radiotherapy for patients with stage Ⅰ non-small cell lung cancer: Results of a phase 2 clinical trial. Cancer, 2017, 123(16): 3031-3039.
50. Chang JY, Senan S, Paul MA, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage Ⅰ non-small-cell lung cancer: A pooled analysis of two randomised trials. Lancet Oncol, 2015, 16(6): 630-637.
51. Lam A, Yoshida EJ, Bui K, et al. A national cancer database analysis of radiofrequency ablation versus stereotactic body radiotherapy in early-stage non-small cell lung cancer. J Vasc Interv Radiol, 2018, 29(9): 1211-1217.
52. Palussiere J, Lagarde P, Aupérin A, et al. Percutaneous lung thermal ablation of non-surgical clinical N0 non-small cell lung cancer: Results of eight years' experience in 87 patients from two centers. Cardiovasc Intervent Radiol, 2015, 38(1): 160-166.
53. Akeboshi M, Yamakado K, Nakatsuka A, et al. Percutaneous radiofrequency ablation of lung neoplasms: Initial therapeutic response. J Vasc Interv Radiol, 2004, 15(5): 463-470.
54. Palussière J, Chomy F, Savina M, et al. Radiofrequency ablation of stageⅠA non-small cell lung cancer in patients ineligible for surgery: Results of a prospective multicenter phaseⅡ trial. J Cardiothorac Surg, 2018, 13(1): 91.
55. Páez-Carpio A, Gómez FM, Isus Olivé G, et al. Image-guided percutaneous ablation for the treatment of lung malignancies: Current state of the art. Insights Imaging, 2021, 12(1): 57.
56. Shimoyama R, Tsutani Y, Wakabayashi M, et al. A multi-institutional randomized phaseⅢ trial comparing anatomical segmentectomy and wedge resection for clinical stageⅠA non-small cell lung cancer in high-risk operable patients: Japan Clinical Oncology Group Study JCOG1909 (ANSWER study). Jpn J Clin Oncol, 2020, 50(10): 1209-1213.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Controversy over surgical modalities for early non-small cell lung cancer

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