Multicenter prospective study of sublobar resection for c-Stage I non-small cell lung cancer among patients with little physical preservation for lobectomy (KLSG-0801)

Abstract

Local therapies for stage I non-small cell lung cancer (NSCLC) are divided into surgical and radiation therapies among patients with limited physical preservation for lobectomy. A prospective Phase II study of stereotactic body radio therapy (SBRT) (JCOG0403) revealed that the overall 3-year survival rate (3-YSR) was 76.0%, the 3-year progression-free survival rate (3-YPFR) was 69.0%, and the rate of morbidity ≥ grade 3 was 9%. However, there have been few reports of prospective multicenter studies regarding surgery for stage I NSCLC among high-risk patients. Thus, we investigated this in the setting of a prospective multicenter observational study. Thirty-two high-risk NSCLC patients were accrued, with 30 males, and a median age of 74 years (61-85 years). There were 2 cases of morbidity ≥ grade 3 (6.3%) but no postoperative deaths. The margin local control rate was 96.9% (1 surgical margin recurrence), local recurrence control rate was 75.0% (8 recurrences in the ipsilateral thorax), 3-YSR was 79.0%, and 3-YRFR was 75.9%. Sublobar pulmonary resection among patients with limited physical preservation for lobectomy with stage I non-small cell lung cancer (NSCLC) provides safe and feasible results comparable with those of SBRT.