February 10, 2011

Less invasive lung cancer surgery studied

Less invasive lung cancer surgery studied

For years, the standard treatment for some early lung cancers was to remove the entire affected lobe. The recurrence of cancer was low, but the procedure was invasive and unnecessarily removed normal lung tissue not affected by the tumors.

Vanderbilt's Department of Thoracic Surgery and the Vanderbilt-Ingram Cancer Center have joined a National Cancer Institute clinical trial to determine if patients could remain equally as disease free with less invasive, lung-sparing surgery.

Eric Grogan, M.D., MPH

Eric Grogan, M.D., MPH

“Our hope is that we can provide the same long-term survival rates that current lobectomy surgery offers, while removing less lung tissue in a less invasive way,” said Eric Grogan, M.D., MPH, principal investigator of the Phase III clinical trial.

Recent studies have shown promising results when selectively removing only those portions of the affected lung in lesions less than 2 centimeters.

Already, thoracic surgeons at Vanderbilt have been performing the minimally invasive surgery on patients with lung cancer and highly impaired lung function due to emphysema.

The national clinical trial at Vanderbilt will include patients who have recently been diagnosed with non-small cell lung cancer and who have lesions less than 2 centimeters in size located near the periphery of the lung.

This outer location makes it easier to perform more targeted surgical removal. Additionally, patients who have suspicious lesions may also be included if cancer is found at the time of resection.

Patients participating in the clinical trial will be randomly assigned either the sublobar resection — localized removal of only a small portion of the lung — or complete lobectomy. Chemotherapy may be administered following surgery, if determined necessary.

These patients will then receive clinical care and follow-up for five years, to determine if the sublobar resection is as effective as the lobectomy.

“Our research-driven, patient-centered approach provides the most innovative treatment for our patients, including the use of smaller incisions and cameras, all of which aid in even faster recovery times,” said Joe B. (Bill) Putnam Jr., M.D., chair of the Department of Thoracic Surgery. “This clinical trial supports our broad philosophy to personalize each operation for each individual patient as a means of providing the best care.

The clinical trial is coordinated by the Cancer and Leukemia Group B and supported by the American College of Surgeons Oncology Group. Both of these national clinical research groups are sponsored by the National Cancer Institute.