Lobar versus Sublobar Resection in the Elderly for Early Lung Cancer

Dr Harish Mithiran, director of Neumark and senior consultant thoracic surgeon at Gleneagles Hospital Singapore, was part of a research team that performed a systematic review and meta-analysis of outcomes of lobectomy versus sublobar resection in elderly patients above 65 years old with stage 1 nonsmall cell lung carcinoma (NSCLC).
lobar resection elderly lung cancer


Twelve studies out of 5,824 were specifically selected to be part of the meta-analysis. The results indicate that in the elderly, lobectomy for stage 1 NSCLC confers a survival advantage over sublobar resection. Lobectomy patients had a lower risk of death within 5 years and lower odds of local cancer recurrence. The research results indicated that lobectomy had a better 5-year cancer-specific survival and 5-year disease-free survival that trended toward significance.

The sublobar resection group showed better 30-day operative mortality that trended toward significance. Subgroup analysis of stage 1A cancer demonstrated no difference in 5-year overall survival rates. However, for stage 1B tumors 5-year overall survival favored lobectomy.

The research team concluded that lobectomy for stage 1 NSCLC in elderly patients is superior to sublobar resection in terms of survival and cancer recurrence and should be afforded where possible. For stage 1A tumors, sublobar resection is noninferior and may be considered.


Read full article in The Thoracic and Cardiovascular Surgeon



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