Survival after Sublobar Resection for Early-Stage Lung Cancer: Methodological Obstacles in Comparing the Efficacy to Lobectomy
The authors provide a comprehensive and exhaustive review of the literature comparing lobectomy to sublobar resection for treatment of early stage NSCLC. The focus of the study was to highlight the methodological differences used and determine if comparisons between studies can be made. Twenty-three studies met the inclusion criteria for this review, 4 showing no difference in survival between lobectomy and sublobar resection, 13 favoring lobectomy, and 6 favoring sublobar resection. The authors point out that selection bias likely occurred as these studies were all observational. Given the heterogeneity in study design and data analysis among these 23 studies, the authors were unable to provide a metaestimate comparing the two resection strategies and suggest that standardizing study design, analysis, and reporting of outcomes may allow for better comparison.
As it is clear from this review. The available studies up till now are observational studues and gave no deffinite answers about what is the best surgical treatment for early lung cancer.
Till we have solid evudence based on randomized trials. I would suggest lobectmoy if the patient fit enough to withstand the operation otherwise segmentectomy or wedge will be avaiable option.