Our Summary

In recent years, the use of low-dose and high-resolution CT scans has led to an increase in the detection of early-stage non-small cell lung cancer. This has prompted chest surgeons to explore more effective methods of removing these cancers. Research has shown that patients who have no cancer cells at the edge of the tissue removed (negative margins) have lower rates of the cancer coming back compared to those who do have cancer cells at the edge of the removed tissue (positive margins). Therefore, ensuring negative margins during a type of surgery called sublobar resection, which removes a portion of the lung, is very important when treating early-stage lung cancer. This paper will discuss the current research and progress in this area.

FAQs

  1. What is the significance of having a negative lung margin during sublobar resection for early-staged lung cancer?
  2. How has the use of low-dose computed tomography (LDCT) and high-resolution CT (HRCT) impacted the discovery rate of early-staged non-small cell lung cancer?
  3. What is the relationship between local tumor recurrence and the status of lung margins in early-stage lung cancer patients?

Doctor’s Tip

A doctor might tell a patient undergoing lung resection surgery to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding smoking or exposure to secondhand smoke to promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for lung resection include those with early-stage non-small cell lung cancer, especially those with negative lung margins. These patients may benefit from sublobar resection to ensure a lower rate of local tumor recurrence. The use of low-dose computed tomography (LDCT) and high-resolution CT (HRCT) has improved the detection rate of early-stage lung cancer, leading to more thoracic surgeons exploring more reasonable resection scopes for these patients. It is important to ensure negative margins during sublobar resection in order to reduce the risk of local recurrences.

Timeline

Before lung resection:

  1. Patient is diagnosed with early-staged non-small cell lung cancer through LDCT or HRCT.
  2. Thoracic surgeon discusses treatment options with the patient, including the possibility of sublobar resection.
  3. Pre-operative evaluation and testing, including pulmonary function tests and imaging studies, are conducted to assess the patient’s fitness for surgery.
  4. Patient undergoes informed consent process and pre-operative preparations.

After lung resection:

  1. Patient undergoes sublobar resection surgery to remove the tumor and ensure negative lung margins.
  2. Post-operative care and monitoring in the hospital to manage pain, prevent complications, and promote healing.
  3. Follow-up appointments with the surgeon to monitor recovery and assess for any signs of recurrence.
  4. Long-term surveillance with regular imaging studies to monitor for any recurrence of lung cancer.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung resection include:

  1. What are the different types of lung resection procedures available for treating early-staged non-small cell lung cancer?
  2. How will the surgical margin be determined during the sublobar resection procedure?
  3. What are the potential risks and complications associated with lung resection surgery?
  4. How long is the recovery period after lung resection surgery and what can I expect during the recovery process?
  5. What is the likelihood of local tumor recurrence if the lung margin is positive after surgery?
  6. Are there any alternative treatment options available for early-staged lung cancer besides lung resection?
  7. How often will I need follow-up appointments and imaging scans to monitor for recurrence after lung resection surgery?
  8. How can I best prepare for lung resection surgery in terms of lifestyle changes, medications, and post-operative care?
  9. What are the success rates and long-term outcomes for patients who undergo lung resection surgery for early-staged lung cancer?
  10. Are there any specific factors about my individual case that may impact the effectiveness of lung resection surgery and the likelihood of recurrence?

Reference

Authors: Wang Z, Ge M. Journal: Zhongguo Fei Ai Za Zhi. 2018 Jun 20;21(6):498-502. doi: 10.3779/j.issn.1009-3419.2018.06.11. PMID: 29945710