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Outcome of thoracoscopic anatomical sublobar resection under 3-dimensional computed tomography simulation

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Abstract

Background

Previous studies have reported the feasibility and efficacy of thoracoscopic anatomical sublobar resection under three-dimensional computed tomography (3DCT) simulation; however, its long-term outcomes have not been clearly established in primary lung cancer. This study aimed to evaluate the long-term outcomes of this technique.

Methods

We retrospectively reviewed data from 112 consecutive patients with selected clinical stage IA non-small cell lung cancer (NSCLC) who underwent thoracoscopic anatomical sublobar resection from 2004 to 2014. This procedure was planned using preoperative 3DCT simulation to ensure sufficient surgical margins and enabled tailor-made surgery for each patient. Patients who had predominantly ground glass opacity lung cancers underwent anatomical sublobar resection as a curative-intent resection. Other patients who were high-risk candidates for lobectomy underwent anatomical sublobar resection as a compromised limited resection.

Results

Of the 112 cases, 82 had a curative-intent resection, while 30 had a compromised limited resection. Recurrence occurred in only 2 cases (1.8%), both of which were in the compromised limited group. A second primary lung cancer was observed in 5 cases (4.5%). Of the 5 patients, 4 underwent surgery for a second cancer and had no recurrence. The 5-year overall survival, lung cancer-specific overall survival, and recurrence-free survival rates were 92.5%, 100%, and 98.2%, respectively, for all cases; 97.6%, 100%, and 100%, respectively, in the curative-intent group; and 75.8%, 100% and 92.6%, respectively, in the compromised limited group.

Conclusions

Thoracoscopic anatomical sublobar resection under 3DCT simulation may be an acceptable alternative treatment in selected patients with NSCLC.

Trial and clinical registry

Clinical registration number: IRB No. 2020-98 (Dated: 2020.6.30).

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Authors and Affiliations

  1. Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Akira Hamada, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Kenta Nakahashi, Satoshi Takamori & Mitsuaki Sadahiro

  2. Department of Public Health and Hygiene, Yamagata University Graduate School of Medical Science, Yamagata, Japan

    Ri Sho

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  1. Akira Hamada
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  2. Hiroyuki Oizumi
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  3. Hirohisa Kato
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  4. Jun Suzuki
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  5. Kenta Nakahashi
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  6. Satoshi Takamori
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  7. Ri Sho
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  8. Mitsuaki Sadahiro
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Correspondence to Akira Hamada.

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Disclosures

Akira Hamada, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Kenta Nakahashi, Satoshi Takamori, Ri Sho, and Mitsuaki Sadahiro have no conflicts of interest or financial ties to disclose.

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Hamada, A., Oizumi, H., Kato, H. et al. Outcome of thoracoscopic anatomical sublobar resection under 3-dimensional computed tomography simulation. Surg Endosc 36, 2312–2320 (2022). https://doi.org/10.1007/s00464-021-08506-x

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