Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston,MA 02118, USA.
Cancer J. 2011 Jan-Feb;17(1):23-7. doi: 10.1097/PPO.0b013e31820a51b6.
Currently, lobectomy is the preferred treatment for early-stage, non-small cell lung cancer primarily because of the increased local recurrence rate that has been reported with sublobar resection. Sublobar resection is typically used for high-risk, but still operable, patients with lung cancer. Several recent studies have demonstrated comparable recurrence and survival rates between lobectomy and sublobar resection for small, stage I lung cancers. In particular, attention to technical details such as performing a segmentectomy or a wide wedge resection (rather than a simple wedge resection), or the addition of brachytherapy, can result in improved outcomes. Also, the potential for better preservation of pulmonary function with sublobar resection has fueled the debate arguing for sublobar resections even for patients who are considered to be "good risk" and able to tolerate a lobectomy. This article reviews the current status of sublobar resection for early-stage lung cancer, with particular attention to issues such as tumor size, type of sublobar resection, use of adjuvant brachytherapy, and preservation of pulmonary function.
目前，肺叶切除术是治疗早期非小细胞肺癌的首选方法，主要是因为亚肺叶切除术后局部复发率较高。亚肺叶切除术通常用于高危但仍可手术的肺癌患者。最近的几项研究表明，对于小的 I 期肺癌，肺叶切除术和亚肺叶切除术的复发率和生存率相当。特别是，注意技术细节，如进行段切除术或广泛楔形切除术（而不是简单的楔形切除术），或加入近距离放疗，可以改善结果。此外，亚肺叶切除术可以更好地保留肺功能，这也引发了一场争论，即即使对于被认为“低危”且能够耐受肺叶切除术的患者，也应该进行亚肺叶切除术。本文回顾了早期肺癌亚肺叶切除术的现状，特别关注肿瘤大小、亚肺叶切除术类型、辅助近距离放疗的应用以及肺功能的保护等问题。
