Radomized multicenter trial to compare standard lobectomy versus anatomical segmentectomy each plus radical lymphadenectomy in patients with Non-Small Cell Lung Cancer (NSCLC) pT1a pN0 cM0, Stage IA

• Applicant: Professor Dr. Georgios Stamatis
• Subject Area: General and Visceral Surgery
• Term: from 2013 to 2018
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 222683767

Lobectomy plus lymphadenectomy is the standard procedure in early stage IA NSCLC (pT1a pN0 cM0) since the 1990ties. However, segmentectomy is known for a lower (< 1 % compard to 2 %) 30 day inhospital mortality and less morbidity (10 % compared to 15 – 20 %). Moreover, better lung function and an improved quality of life can be expected for segmentectomy being the less invasive operation, leaving more lungparenchyma. A randomized trial by Ginsberg and Rubinstein (1995) compared lobectomy vs. segmentectomy and reported an advantage for lobectomy. However, the patient population analysed was very heterogeneous including non-anatomical wedge- and anatomical segmental resections. Studies in selected patients with relevant functional cardiac or pulmonary disorders who received segmentectomies showed similar oncological and better functional outcomes compared to standard lobectomy, which lead to the idea that segmentectomy might be the procedure of choice in all patients with early stage IA if all known criteria of different, mostly retrospective studies (no lymph node-involvement, tumor size of less than 2 cm, tumor-free resection margins of at least 2 cm) are taken into account. Up to now no study investigated these aspects jointly in a prospective randomized controlled trial.

• DFG Programme: Clinical Trials
• Participating Person: Dr. Matthias Altmayer