Less Extensive Surgery Is Just as Effective as Larger Surgery for Some Early Lung Cancers
15 Mar 2023
Clinical ResultRadiation Therapy
Hackensack Meridian Jersey Shore University Medical Center Chairman of Surgery Dr. Thomas Bauer Is Part of International Multicenter Research Team
NEPTUNE, N.J., March 15, 2023 /PRNewswire/ -- Hackensack Meridian Jersey Shore University Medical Center investigators were part of an international study at multiple centers showing that removing just the part of a lung containing an early-stage lung cancer was as effective as taking out an entire lung lobe, without putting patients at greater risk of a recurrence or poor survival. The findings of the clinical trial, published in the February 9, 2023, issue of the New England Journal of Medicine, could change the standard of care for some people with small cancers in the outer areas of the lung (periphery) that have not spread.
"The results of this clinical trial are very important and may change the way we manage early-stage lung cancer," explained Thomas Bauer, MD, chairman of surgery at Hackensack Meridian Jersey Shore University Medical Center, who was one of the study's lead authors. "We also witnessed a trend toward better breathing ability in patients who had less lung tissue removed, which could be especially beneficial for people with reduced respiratory function."
Lobectomy — removal of a lung lobe — has been the standard surgery for people with stage 1 non-small cell lung cancer (NSCLC) that has not spread to the nearby lymph nodes or other parts of the body. But newer imaging and staging methods, including lung cancer screening with CT scanning, have helped doctors find smaller and earlier tumors. Surgeons have questioned if some of these patients can have "sublobar resection" (removal of just the tumor and some tissue around it, rather than the whole lung lobe) without worsening their outcomes.
In this study, researchers randomly assigned 697 patients with peripheral stage 1 NSCLC to undergo either lobectomy (357 patients) or sublobar resection (340 patients). All patients had tumors that were 2 cm or less in size and had not spread to the lymph nodes ("node-negative"). After a median follow-up of 7 years, the rate of recurrence and overall survival were similar between the two groups. Five years later, the rate of recurrence was 64.1% after lobectomy and 63.6% after sublobar resection; 5-year overall survival was 78.9% and 80.3%, respectively.
Patients in the sublobar resection group had forced expiratory volume rates (a measure of lung function) that were 2 percentage points better than the lobectomy group. Forced vital capacity, another measure of breathing ability, was also slightly better for the sublobar resection patients.
The authors concluded that sublobar resection is an effective treatment for people with stage 1 node-negative NSCLC and small tumors. They added that these findings will become increasingly relevant as the proportion of patients with early-stage lung cancer increases as lung cancer screening expands, and as there are more older patients with early-stage disease for whom sublobar resection may be the preferred surgery.
For information about thoracic surgery services at Jersey Shore University Medical Center, visit www.hackensackmeridianhealth.org/en/Services/Surgical-Services/Thoracic-Surgery.
ABOUT HACKENSACK MERIDIAN JERSEY SHORE UNIVERSITY MEDICAL CENTER
Located in Neptune, N.J., Hackensack Meridian Jersey Shore University Medical Center is a not-for-profit teaching hospital and the only Level I Adult and Level II Pediatric Trauma Center in Monmouth and Ocean counties. It is home to K. Hovnanian Children's Hospital – the first children's hospital in these counties. With more than 1,200 physicians and dental staff in 60 specialty areas, Jersey Shore University Medical Center's (JSUMC) team provides high-quality care in a patient-centered, environmentally-friendly setting.
The team's commitment to excellence has earned JSUMC numerous quality accolades, including being named the #6 best hospital in New Jersey, #24 in the NY metro area and high performing in ten specialties, procedures and conditions by U.S. News & World Report for 2022-23. K. Hovnanian Children's Hospital, as part of Hackensack Meridian Children's Health network, is ranked #1 in N.J., in the top 20 in the Mid-Atlantic Region and #34 in the nation in pediatric nephrology care by U.S. News for 2022-23. JSUMC has also received national recognitions demonstrating clinical quality from Healthgrades, including America's 250 Best Hospitals (2021, 2022), 100 Best Hospitals for Stroke Care (2020-2023), 100 Best for Gastrointestinal Surgery (2022-23) and Patient Safety Excellence Awards (2020, 2021) as well as Excellence Awards in Neurosciences (2020-2023), Cranial Neurosurgery (2022-23) and Bariatric Surgery (2021-23). Jersey Shore's programs and services continue to receive numerous national recognitions, including designation as high-performing in cardiac (including American College of Cardiology's HeartCARE Center, National Distinction of Excellence recognition, 2021-22), stroke, surgical and oncology services.
The medical center's clinical research program and longstanding commitment to medical education is evident through an affiliation with Hackensack Meridian School of Medicine and an affiliation with St. George's University School of Medicine. JSUMC serves as an academic center dedicated to advancing medical knowledge, training future physicians and providing the community with access to promising medical breakthroughs.
JSUMC's HOPE Tower, 10-story medical office building, provides a healing outpatient experience. Guided by a patient-centered approach towards care, and informed by the latest medical breakthroughs, HOPE Tower includes advanced imaging services, a clinical academic center, innovative simulation laboratory, state-of-the-art amphitheater, specialty physician offices. It includes a cancer center featuring a range of comprehensive treatment options, including surgical specialties, medical oncology, and the most advanced radiation therapy and minimally invasive interventional therapies. For information, visit HackensackMeridianHealth.org
SOURCE Hackensack Meridian Health
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