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Sawabata et al. Mini-invasive Surg 2017;1:12-23 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.01
www.misjournal.net
Review Open Access

Pulmonary wedge resection for clinical

stage I non-small cell lung cancer: a review

of a mini-invasive treatment

Noriyoshi Sawabata , Akikazu Kawase , Nobumasa Takahashi , Takeshi Kawaguchi , Noriyuki Matsutani
5
2
3
4
1
1 General Thoracic Surgery, Hoshigaoka Medical Center, Osaka 873-8511, Japan.
2 First Department of Surgery, Hamamatsu Medical University School of Medicine, Shizuoka 431-3192, Japan.
3 Department of Respiratory Surgery Saitama Cardiovascular and Respiratory Center, Saitama 360-0105, Japan.
4 Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara 634-8522, Japan.
5 Department of Surgery, Teikyo University School of Medicine, Tokyo 173-8605, Japan.
Correspondence to: Prof. Noriyoshi Sawabata, General Thoracic Surgery, Hoshigaoka Medical Center, Japan Community Healthcare Organization,
4-8-1 Hoshigaoka, Hirakata, Osaka 873-8511, Japan. E-mail: nsawabata@hotmail.com
How to cite this article: Sawabata N, Kawase A, Takahashi N, Kawaguchi T, Matsutani N. Pulmonary wedge resection for clinical stage I non-small
cell lung cancer: a review of a mini-invasive treatment. Mini-invasive Surg 2017;1:12-23.
ABSTRACT
Article history: Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related deaths in
Received: 05-01-2017 the world. Therefore, there is a need to intensify treatments of these tumors. Because stage
Accepted: 13-03-2017 I NSCLC is a nonmetastatic disease, local therapies are indicated, among which surgery is
Published: 31-03-2017 the most commonly deployed strategy. Pulmonary wedge/sublobar resection is therefore
discussed in comparison to stereotactic body radiation therapy for stage I lung cancer. Review
Key words: of retrospective and prospective clinical trials reveal similar outcomes for both strategies,
Non-small cell lung cancer, while a multicenter randomized prospective study comparing the efficacy of both therapies is
wedge resection, on-going. Because the results of pulmonary wedge/sublobar resection may depend on tumor
sublobar resection, size, tumor-distance from surgical margin, tumor size-to-margin distance ratio, and margin
stage I, cytology, prospective studies to evaluate the clinical implications of these factors, so as to
stereotactic body radiation therapy inform patient prognostication, are recommended.

INTRODUCTION local therapies for stage I lung cancer are defined
by the amount of lung tissue targeted or resected.
The need for less invasive treatment strategies has These include segmentectomy and wedge resection
been increasing, partly due to the increase in the (wedge/sublobar resection), radiation, radiofrequency
ageing population. Because stage I lung cancer is a ablation, [3,4] and cryoablation therapies. Currently, the
[1]
[5]
localized disease without evidence of metastases and most commonly used strategies are wedge/sublobar
[2]
is associated with low morbidity and mortality, minimally resection and radiation therapy, including stereotactic
invasive (mini-invasive) local therapies are central to body radiation therapy (SBRT). We therefore review
managing the high-risk or medically unfit patent such pulmonary wedge/sublobar resection in comparison to
as the elderly. The various types of mini-invasive SBRT for stage I lung cancer.

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