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Dolan et al. Mini-invasive Surg 2021;5:3 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.101

Review Open Access

Sublobar resection in high-risk patients for
lobectomy: current and future strategy

Daniel P. Dolan, Scott J. Swanson

Division of Thoracic Surgery, Brigham and Women’s Hospital, Boston, MA 02215, USA
Correspondence to: Dr. Daniel P. Dolan, Division of Thoracic Surgery, Brigham and Women’s Hospital, 75 Francis St., Boston, MA
02215, USA. E-mail: ddolan7@bwh.harvard.edu

How to cite this article: Dolan DP, Swanson SJ. Sublobar resection in high-risk patients for lobectomy: current and future strategy.
Mini-invasive Surg 2021;5:3. http://dx.doi.org/10.20517/2574-1225.2020.101

Received: 27 Oct 2020 First Decision: 26 Nov 2020 Revised: 8 Dec 2020 Accepted: 14 Dec 2020 Published: 7 Jan 2021

Academic Editor: Noriyoshi Sawabata Copy Editor: Whitney Xu Production Editor: Jing Yu

Abstract
Surgical resection by lobectomy is the gold standard of therapy for early stage non-small cell lung cancer. However,
not all patients are medically fit to undergo surgery. In patients considered high-risk for lobectomy, alternative
strategies have been developed including radiofrequency ablation, cryoablation, microwave ablation, stereotactic
radiation therapy, wedge resection, and segmentectomy. This work reviews the definition of high-risk, and the
outcomes that have been associated with each treatment technique. Some technical points regarding wedge
resection versus segmentectomy are noted. Future directions are discussed in the context of treatment for patients
considered at high-risk for lobectomy.

Keywords: Non-small cell lung cancer, sublobar resection, surgical technique, high-risk patients

INTRODUCTION
This work is intended to review the current literature surrounding the definition of a patient with lung-
cancer who is considered high-risk for lobectomy, discuss different treatment modalities and their
outcomes for these patients, and note some potential future directions and their benefits to high-risk
patients. PubMed and EMBASE were reviewed and works were included based on relevance. Previous work
in this field has involved clinical trials to determine patients who are considered high-risk, their results with
sublobar resection, radiofrequency ablation (RFA), cryoablation, microwave ablation (MWA), stereotactic
body radiation therapy (SBRT), and comparisons of these alterative techniques against sublobar resection.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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