Parenchymal-Sparing Resections: Why, When, and How

Historically, the rates of local recurrence of non-small cell lung cancer have been higher with sublobar resection than with lobectomy. Recent data from Japan and the United States show that sublobar resection of small tumors (especially those ≤ 2 cm) can be performed with no significant difference in local recurrence or long-term survival. Recurrence rates can be reduced further by achieving an adequate margin of resection. The use of intraoperative brachytherapy mesh implants during sublobar resection may help minimize the risk of local recurrence. For larger tumors, or when adequate surgical margins are not obtainable, lobectomy should be performed.