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Surgical Workup and Management of Early-Stage Lung Cancer

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Advances in Radiation Oncology in Lung Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Lung cancer remains the leading cause of cancer-related deaths within the United States (National Cancer Institute Surveillance, Epidemiology, and End Results Program 2021a). Overall survival (OS) remains dismal at 21% at 5 years (National Cancer Institute Surveillance, Epidemiology, and End Results Program 2021b). Treatments for lung cancer include multiple modalities, including surgical resection, systemic treatment (chemotherapy or immunotherapy), and radiation, and depends on clinical staging. For early-stage lung cancers, stage I and II, surgery remains the preferred treatment and provides the best opportunity for curative intent. Surgical indications also extend to a portion of patients with stage IIIA disease (Lang-Lazdunski 2013) but this will not be discussed in this chapter.

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References

  • Abbas A, Kadakia S, Ambur V, Muro K, Kaiser L (2017) Intraoperative electromagnetic navigational bronchoscopic localization of small, deep, or subsolid pulmonary nodules. J Thorac Cardiovasc Surg 153(6):1581–1590

    Google Scholar 

  • ADL S, Cardoso (eds) (2012) The evolution of VATS lobectomy. Topics in thoracic surgery. InTech, Shanghai, pp 181–210

    Google Scholar 

  • Altorki NK, Wang X, Wigle D et al (2018) Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: post-hoc analysis of an international, randomized, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med 6(12):915–924

    Google Scholar 

  • American Cancer Society (2021) Cancer facts and figures 2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf. Accessed 15 Apr 2021

  • Aokage K, Saji H, Suzuki K et al (2017) 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 65(5):267–272

    Google Scholar 

  • Asamura H, Hishida T, Suzuki K et al (2013) Radiographically determined noninvasive adenocarcinoma of the lung: survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg 146(1):24–30

    Google Scholar 

  • Asamura H, Okada M, Saji H et al (2021) Randomized trial of segmentectomy compared to lobectomy in small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). In: American Association for Thoracic Surgery, 101st Annual Meeting; 2021 Apr 30–May 2; Virtual meeting. Abstract 163

    Google Scholar 

  • Battoo A, Jahan A, Yang Z et al (2014) Thoracoscopic pneumonectomy: an 11-year experience. Chest 146(5):1300–1309

    Google Scholar 

  • Brunelli A (2010) Risk assessment for pulmonary resection. Semin Thorac Cardiovasc Surg 22(1):2–13

    Google Scholar 

  • Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ (2013) Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143(5 Suppl):e166S–e190S

    Google Scholar 

  • Cao C, Manganas C, Ang SC, Yan TD (2012) A systematic review and meta-analysis on pulmonary resections by robotic video-assisted thoracic surgery. Ann Cardiothorac Surg 1(1):3–10

    Google Scholar 

  • Darling GE, Allen MS, Decker PA et al (2011) Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial. J Thorac Cardiovasc Surg 141(3):662–670

    Google Scholar 

  • de Koning HJ, van der Aalst CM, de Jong PA et al (2020) Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med 382(6):503–513

    Google Scholar 

  • Deslauriers J, Grégoire J, Jacques LF, Piraux M, Guojin L, Lacasse Y (2004) Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences. Ann Thorac Surg 77:1152–1156

    Google Scholar 

  • Detterbeck FC, Boffa DJ, Kim AW, Tanoue LT (2017) The eighth edition of lung cancer stage classification. Chest 151(1):193–203

    Google Scholar 

  • Donahue JM, Morse CR, Wigle DA, Allen MS, Nichols FC, Shen KR et al (2012) Oncologic efficacy of anatomic segmentectomy in stage IA lung cancer patients with T1a tumors. Ann Thorac Surg 93(2):381–387

    Google Scholar 

  • Donington J, Ferguson M, Mazzone P, Handy J Jr, Schuchert M, Fernando H et al (2012) American College of Chest Physicians and Society of Thoracic Surgeons consensus statement for evaluation and management for high-risk patients with stage I non-small cell lung cancer. Chest 142(6):1620–1635

    Google Scholar 

  • El-Sherif A, Gooding WE, Santos R et al (2006) Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surg 82(2):408–415

    Google Scholar 

  • Ettinger DS, Wood DE, Aisner DL et al (2021) NCCN guidelines insights: non-small cell lung cancer, Version 2.2021. J Natl Compr Canc Netw 19(3):254–266

    Google Scholar 

  • Ferrari-Light D, Geraci TC, Sasankan P, Cerfolio RJ (2019) The utility of near-infrared fluorescence and indocyanine green during robotic pulmonary resection. Front Surg 6:47

    Google Scholar 

  • Fleisher LA, Beckman JA, Brown KA et al (2007) ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation 116(17):e418–e499

    Google Scholar 

  • Fleisher LA, Fleischmann KE, Auerbach AD et al (2014) 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. Circulation 130:e278–e333

    Google Scholar 

  • Flores RM, Park BJ, Dycoco J et al (2009) Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer. J Thorac Cardiovasc Surg 138(1):11–18

    Google Scholar 

  • Gamsu G, Klein JS (1989) High resolution computed tomography of diffuse lung disease. Clin Radiol 40(6):554–556

    Google Scholar 

  • Gao SJ, Kim AW, Puchlaski JT et al (2017) Indications for invasive mediastinal staging in patients with early non-small cell lung cancer staged with PET-CT. Lung Cancer 109:36–41

    Google Scholar 

  • Gao HJ, Jiang ZH, Gong L et al (2019) Video-assisted vs thoracotomy sleeve lobectomy for lung cancer: a propensity matched analysis. Ann Thorac Surg 108(4):1072–1079

    Google Scholar 

  • Gazdar AF, Minna JD (2009) Multifocal lung cancers—clonality vs field cancerization and does it matter? J Natl Cancer Inst 101(8):541–543

    Google Scholar 

  • Geraci TC, Ferrari-Light D, Kent A, Michaud G, Zervos M, Pass HI et al (2019) Technique, outcomes with navigational bronchoscopy using indocyanine green for robotic segmentectomy. Ann Thorac Surg 108(2):363–369

    Google Scholar 

  • Geraci T, Ferrari-Light D, Wang S et al (2020) Robotic sleeve resection of the airway: outcomes and technical conduct using video vignettes. Ann Thorac Surg 110(1):236–240

    Google Scholar 

  • Ghaly G, Kamel M, Nasar A et al (2016) Video-assisted thorascoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stage I non-small cell lung cancer. Ann Thorac Surg 101(2):465–472

    Google Scholar 

  • Gonzalez-Rivas D, Paradela M, Fernandez R et al (2013) Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg 95(2):426–432

    Google Scholar 

  • Groth SS, Burt BM, Surgarbaker DJ (2015) Management of complications after pneumonectomy. Thorac Surg Clin 25(3):335–348

    Google Scholar 

  • Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246(3):697–722

    Google Scholar 

  • Hattori A, Matsunaga T, Hayashi T, Takamochi K, Oh S, Suzuki K (2017) Prognostic impact of the findings on thin-section computed tomography in patients with subcentimeter non-small cell lung cancer. J Thorac Oncol 12(6):954–962

    Google Scholar 

  • Henschke CI, McCauley DI, Yankelevitz DF et al (1999) Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 354(9173):99–105

    Google Scholar 

  • Henschke CI, Yankelevitz DF, Mirtcheva R et al (2002) CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol 178(5):1053–1057

    Google Scholar 

  • Hou B, Deng XF, Zhou D, Liu QX, Dai JG (2016) Segmentectomy versus wedge resection for the treatment of high-risk operable patients with stage I non-small cell lung cancer: a meta-analysis. Ther Adv Resp Dis 10(5):435–443

    Google Scholar 

  • Howington JA, Blum MG, Chang AC, Balekian AA, Murthy SC (2013) 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 143(5 Suppl):e278S–e313S

    Google Scholar 

  • Huang X, Wang J, Chen Q, Jiang J (2014) Mediastinal lymph node dissection versus mediastinal lymph node sampling for early stage non-small cell lung cancer: a systematic review and meta-analysis. PLoS One 9(10):e109979

    Google Scholar 

  • Hürter T, Hanrath P (1992) Endobronchial sonography: feasibility and preliminary results. Thorax 47:565–567

    Google Scholar 

  • Jiang J, Chang SH, Kent AJ, Geraci TC, Cerfolio RJ (2020) Current novel advances in bronchoscopy. Front Surg 7:596925. Epub 2020/12/12

    Google Scholar 

  • Jiao W, Zhao Y, Qiu T, Xuan Y, Sun X, Qin Y et al (2019) Robotic bronchial sleeve lobectomy for central lung tumors: technique and outcome. Ann Thorac Surg 108:211–218

    Google Scholar 

  • Keller SM, Adak S, Wagner H, Johnson DH (2000) Mediastinal lymph node dissection improves survival in patients with stages II and IIIa non-small cell lung cancer. Eastern Cooperative Oncology Group. Ann Thorac Surg 70(2):358–365

    Google Scholar 

  • Kent M, Wang T, Whyte R, Curran T, Flores R, Gangadharan S (2014) Open, video-assisted thoracic surgery, and robotic lobectomy: review of a national database. Ann Thorac Surg 97(1):236–244

    Google Scholar 

  • Krebs ED, Mehaffey JH, Sarosiek BM, Blank RS, Lau CL, Martin LW (2020) Is less really more? Reexamining video-assisted thoracoscopic versus open lobectomy in the setting of an enhanced recovery protocol. J Cardiovasc Thorac Surg 159(1):284–294

    Google Scholar 

  • Kutschera W (1984) Segment resection for lung cancer. Thorac Cardiovasc Surg 32:102–104

    Google Scholar 

  • Landreneau RJ, Normolle DP, Christie NA et al (2014) Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage I non-small-cell lung cancer: a propensity-matched analysis. J Clin Oncol 32(23):2449–2455

    Google Scholar 

  • Lang-Lazdunski L (2013) Surgery for nonsmall cell lung cancer. Eur Respir Rev 22(129):382–404

    Google Scholar 

  • Lardinois D, De Leyn P, Van Schil P et al (2006) ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer. Eur J Cardiothorac Surg 30(5):787–792

    Google Scholar 

  • Lee PC, Port JL, Korst RJ, Liss Y, Meherally, Altorki NK (2007) Risk factors for occult mediastinal metastases in clinical stage I non-small cell lung cancer. Ann Thorac Surg 84(1):177–181

    Google Scholar 

  • Lewis RJ, Caccvale RJ, Sisler GE, Bocage JP, Mackenzie JW (1997) One hundred video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading. Ann Thorac Surg 63(5):1415–1421

    Google Scholar 

  • Mack MJ, Scruggs GR, Kelly KM et al (1997) Video-assisted thoracic surgery: has technology found its place? Ann Thorac Surg 64:211–215

    Google Scholar 

  • Mazzella A, Pardolesi A, Maisonneuve P et al (2018) Bronchopleural fistula after pneumonectomy: risk factors and management, focusing on open-window thoracostomy. Semin Thorac Cardiovasc Surg 30(1):104–113

    Google Scholar 

  • McDonald F, De Waele M, Hendriks LE, Faivre-Finn C, Dingemans AC, Van Schil PE (2017) Management of stage I and II nonsmall cell lung cancer. Eur Respir J 49(1):1600764

    Google Scholar 

  • McKenna RJ (1994) Lobectomy by video-assisted thoracic surgery with mediastinal node sampling for lung cancer. J Thorac Cardiovasc Surg 107:879–882

    Google Scholar 

  • McKenna RJ Jr, Wolf RK, Brenner M, Fischel RJ, Wurnig P (1998) Is lobectomy by video-assisted thoracic surgery an adequate cancer operation? Ann Thorac Surg 66(6):1903–1908

    Google Scholar 

  • Meyers BF, Hadded F, Siegel BA et al (2006) Cost-effectiveness of routine mediastinoscopy in computed tomography- and positron emission tomography-screened patients with stage I lung cancer. J Thorac Cardiovasc Surg 131(4):822–829

    Google Scholar 

  • Mokhles S, Macbeth F, Treasure T et al (2017) Systematic lymphadenectomy versus sampling of ipsilateral mediastinal lymph-nodes during lobectomy for non-small-cell lung cancer: a systematic review of randomized trials and a meta-analysis. Eur J Cardiothorac Surg 51(6):1149–1156

    Google Scholar 

  • Moore W, Talati R, Bhattacharji P, Bilfinger T (2015) Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol 26:312–319

    Google Scholar 

  • Naidich DP, Bankier AA, MacMahon H et al (2013) Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society. Radiology 266(1):304–317

    Google Scholar 

  • National Cancer Institute Surveillance, Epidemiology, and End Results Program (2021a) Cancer stat facts: common cancer sites. https://seer.cancer.gov/statfacts/html/common.html. Accessed 15 Apr 2021

  • National Cancer Institute Surveillance, Epidemiology, and End Results Program (2021b) Cancer stat facts: lung and bronchus cancer. https://seer.cancer.gov/statfacts/html/lungb.html. Accessed 15 Apr 2021

  • National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (2021) Non-small cell lung cancer. V 4.2021, updated 3 Mar 2021. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed 15 Apr 2021

  • National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365(5):395–409

    Google Scholar 

  • Nomori H, Okada M (2012) Illustrated anatomical segmentectomy for lung cancer. Springer, Tokyo

    Google Scholar 

  • Oh JY, Kwon SY, Yoon HI et al (2007) Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT. Lung Cancer 55(1):67–73

    Google Scholar 

  • Oh S, Suzuki K, Miyasaka Y, Matsunaga T, Tsushima Y, Takamochi K (2013) New technique for lung segmentectomy using indocyanine green injection. Ann Thorac Surg 95:2188–2190

    Google Scholar 

  • Pan X, Gu C, Wang R, Zhao H, Shi J, Chen H (2016) Initial experience of robotic sleeve resection for lung cancer patients. Ann Thorac Surg 102:1892–1897

    Google Scholar 

  • Park SY, Yoon JK, Park KJ, Lee SJ (2015) Prediction of occult lymph node metastasis using volume-based PET parameters in small-sized peripheral non-small cell lung cancer. Cancer Imaging 15:21

    Google Scholar 

  • Qiu T, Zhao Y, Xuan Y et al (2020) Robotic sleeve lobectomy for centrally located non-small cell lung cancer: a propensity score-weighted comparison with thoracoscopic and open surgery. J Thorac Cardiovasc Surg 160(3):838–846

    Google Scholar 

  • Ray MA, Smeltzer MP, Faris NR, Osarogiagbon RU (2020) Survival after mediastinal node dissection, systematic sampling, or neither for early stage NSCLC. J Thorac Oncol 15(10):1670–1681

    Google Scholar 

  • Raz DJ, Zell JA, Ou SH et al (2007) Natural history of stage I non-small cell lung cancer: implications for early detection. Chest 132:193–199

    Google Scholar 

  • Rienhoff WF (1947) The present status of the surgical treatment of carcinoma of the lung. Ann Surg 125(5):541–564

    Google Scholar 

  • Riquet M, Legras A, Mordant P et al (2014) Number of mediastinal lymph nodes in non-small cell lung cancer: a Gaussian curve, not a prognostic factor. Ann Thorac Surg 98(1):224–231

    Google Scholar 

  • Rusch VW, Asamura H, Watanabe H et al (2009) The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol 4(5):568–577

    Google Scholar 

  • Scholten ET, de Jong PA, de Hoop B et al (2015) Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules? Eur Respir J 45(3):765–773

    Google Scholar 

  • Schuchert MJ, Pettiford BL, Keeley S et al (2007) Anatomic segmentectomy in the treatment of stage I non-small cell lung cancer. Ann Thorac Surg 84(3):926–932

    Google Scholar 

  • Sesti J, Langan RC, Bell J et al (2020) A comparative analysis of long-term survival of robotic versus thoracoscopic lobectomy. Ann Thorac Surg 110(4):1139–1146

    Google Scholar 

  • Shanahan B, O’Sullivan KE, Redmond KC (2019) Robotic sleeve lobectomy recent advances. J Thorac Dis 11:1074–1075

    Google Scholar 

  • Shinde A, Li R, Kim J, Salgia R, Hurria A, Amini A (2018) Stereotactic body radiation therapy (SBRT) for early-stage lung cancer in the elderly. Semin Oncol 45(4):210–219

    Google Scholar 

  • Sihoe ADL (2014) The evolution of minimally invasive thoracic surgery: implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis 6:S604–S617

    Google Scholar 

  • Subramanian M, McMurry T, Meyers BF, Puri V, Kozower BD (2018) Long-term results for clinical stage IA lung cancer: comparing lobectomy and sublobar resection. Ann Thorac Surg 106(2):375–381

    Google Scholar 

  • Suzuki K, Nagai K, Yoshida J, Nishimura M, Nishiwaki Y (2001) Predictors of lymph node and intrapulmonary metastasis in clinical stage IA non-small cell lung carcinoma. Ann Thorac Surg 72(2):352–356

    Google Scholar 

  • Tsutani Y, Miyata Y, Nakayama H et al (2014) Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage IA lung adenocarcinoma: wedge resection or segmentectomy. Chest 145(1):66–71

    Google Scholar 

  • United States National Library of Medicine (2021) Comparison of different types of surgery in treating patients with stage IA non-small cell lung cancer. https://clinicaltrials.gov/ct2/show/NCT00499330. Accessed 4 May 2021

  • Veluswamy RR, Whittaker Brown SA et al (2020) Comparative effectiveness of robotic-assisted surgery for resectable lung cancer in older patients. Chest 157(5):1313–1321

    Google Scholar 

  • Watanabe T, Okada A, Imakiire T, Koike T, Hirono T (2005) Intentional limited resection for small peripheral lung cancer based on intraoperative pathologic exploration. Jpn J Thorac Cardiovasc Surg 53(1):29–35

    Google Scholar 

  • Yang CJ, Yendamuri S, Mayne NR et al (2019) The role of thoracoscopic pneumonectomy in the management of non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg 158(1):252–264

    Google Scholar 

  • Yano M, Yoshida J, Koike T et al (2015) Survival of 1737 lobectomy-tolerable patients who underwent limited resection for cStage IA non-small-cell lung cancer. Eur J Cardiothorac Surg 47(1):135–142

    Google Scholar 

  • Zhang S, Li S, Pei Y et al (2017) Impact of maximum standard uptake value of non-small cell lung cancer on detecting lymph node involvement in potential stereotactic body radiotherapy candidates. J Thorac Dis 9(4):1023–1031

    Google Scholar 

  • Zhang Z, Feng H, Zhao H, Hu J, Liu L, Liu Y et al (2019) Sublobar resection is associated with better perioperative outcomes in elderly patients with clinical stage I non-small cell lung cancer: a multicenter retrospective cohort study. J Thorac Dis 11(5):1838–1848

    Google Scholar 

  • Zhang Y, Fu F, Wen Z et al (2020) Segment location and ground glass opacity ratio reliably predict node-negative status in lung cancer. Ann Thorac Surg 109(4):1061–1068

    Google Scholar 

  • Zhou X, Chen R, Huang G, Liu J (2017) Potential clinical value of PET/CT in predicting occult nodal metastasis in T1-T2N0M0 lung cancer patients staged by PET/CT. Oncotarget 8(47):82437–82445

    Google Scholar 

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Chang, S.H., Scheinerman, J., Jiang, J., Paone, D., Pass, H. (2022). Surgical Workup and Management of Early-Stage Lung Cancer. In: Jeremić, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2022_305

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