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Name of the Trial

Phase III Randomized Study of Lobectomy Versus Sublobar Resection in Patients With Small Peripheral Stage IA Non-Small Cell Lung Cancer (CALGB-140503). See the protocol summary ³.

Principal Investigators

Dr. Nasser Altorki, Cancer and Leukemia Group B; Dr. Harvey Pass, Radiation Therapy Oncology Group; Dr. Daniel Miller, American College of Surgeons Oncology Group; Dr. Kemp Kernstine, Southwest Oncology Group.

Dr. Nasser Altorki Principal Investigator

Why This Trial Is Important

Standard treatment for non-small cell lung cancer (NSCLC) detected at a very early stage is surgical removal of the lobe of the lung in which the tumor is found (lobectomy). Although lobectomy often results in long-term survival, patients may suffer from impaired lung function and may be less likely to be eligible for curative surgery if a second lung cancer develops.

Removing just a portion of the affected lung lobe (sublobar resection) has been shown in some nonrandomized studies to result in similar rates of survival as lobectomy for patients with small tumors (2 centimeters or smaller). However, these studies were not designed to prove definitively that sublobar resection is as good as lobectomy in patients with these small tumors.

In this randomized phase III trial, patients with stage 1A NSCLC measuring 2 centimeters or less and located in the outer third of the lung are randomly assigned to sublobar resection (either wedge resection or segmentectomy) or lobectomy. The researchers will follow the patients for 5 years to compare how long they live without their cancer recurring (disease-free survival). They will also compare how long the patients survive overall, their rates of lung cancer recurrence, and their lung function.

"Current practice is based on research conducted in the late 1980s," said Dr. Altorki. "We think that several developments have changed the way we should treat these small tumors. We now have much better staging and the ability to zero in on smaller tumors on the surface of lung segments.

"If the intervention is successful, this trial is likely to change the way lung cancer is managed surgically for years to come, and this will especially benefit patients who have comorbidities such as emphysema," Dr. Altorki added.

For More Information

See the list of eligibility criteria and contact information ³ or call the NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). The call is toll free and confidential.

Glossary Terms

Surgery to remove a whole lobe (section) of an organ (such as the lungs, liver, brain, or thyroid gland).

A clinical trial in which the participants are not assigned by chance to different treatment groups. Participants may choose which group they want to be in, or they may be assigned to the groups by the researchers.

A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial.

Surgery to remove part of an organ or gland. It may also be used to remove a tumor and normal tissue around it. In lung cancer surgery, segmentectomy refers to removing a section of a lobe of the lung. Also called segmental resection.

Surgery to remove a triangle-shaped slice of tissue. It may be used to remove a tumor and a small amount of normal tissue around it.