ArticleThe Journal of thoracic and cardiovascular surgery2018
Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer.
Article in The Journal of thoracic and cardiovascular surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Wedge Resection vs. Stereotactic Body Radiation Therapy for Clinical Stage I Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis.Frontiers in surgery · 2022Pooled it
- Preoperative and intraoperative localization of small pulmonary nodules for thoracoscopic surgery: a contemporary narrative review.Journal of robotic surgery · 2026Review
- Outcomes Linked to 3N2+1N1 Sampling by Surgery Type: A Commission on Cancer Lung Cancer Quality Metric.Annals of thoracic surgery short reports · 2026Article
- Prognostic impact of the lymph node yield on survival in patients with stage I lung adenocarcinoma receiving sublobar resection.Frontiers in molecular biosciences · 2026Article
- The evolving role of wedge resection in early-stage non-small cell lung cancer: a literature review.Translational lung cancer research · 2025Review
- A novel localization technique for margin distance assessment of deep-seated small pulmonary nodules in thoracoscopic wedge resection: a retrospective study.Quantitative imaging in medicine and surgery · 2025Article
- Inter-prefectural and urban-rural regional disparities in lung cancer surgery: a Japanese nationwide population-based cohort study from 2017 to 2019.Surgery today · 2024Article
- A novel localization device for small pulmonary nodules in thoracoscopic wedge resection with adequate margin distance: a retrospective study.Journal of thoracic disease · 2023Article
- Is wedge a dirty word? Demographic and facility-level variables associated with high-quality wedge resection.JTCVS open · 2023Article
- Wedge resection versus lobectomy in T1 lung cancer patients: a propensity matched analysis.Journal of cardiothoracic surgery · 2023Article
- Wedge resection is an acceptable treatment option for radiologically low-grade lung cancer with solid predominance.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation-part 4: systematic review of evidence involving SBRT and ablation.Journal of thoracic disease · 2022Review
- Wedge resection plus adequate lymph nodes resection is comparable to lobectomy for small-sized non-small cell lung cancer.Frontiers in oncology · 2022Article
- Powered articulation by the SigniaSurgery today · 2021Article
- Definitive lobectomy without frozen section analysis is a treatment option for large or deep nodules selected carefully with clinical diagnosis of malignancy.Thoracic cancer · 2020Article
- The Lnc LINC00461/miR-30a-5p facilitates progression and malignancy in non-small cell lung cancer via regulating ZEB2.Cell cycle (Georgetown, Tex.) · 2020Article
- The role of lymph node assessment along with sublobar resection is now evident, but what about the role of sublobar resection in small non-small cell lung cancer?Journal of thoracic disease · 2019Article
- Prognostic impact of underlying lung disease in pulmonary wedge resection for lung cancer.International journal of clinical oncology · 2019Article
- Is segmentectomy the future?Journal of thoracic disease · 2019Review
- Application of quality metrics to wedge resection for early stage non-small cell lung cancer demonstrates differences in overall survival.Shanghai chest · 2019Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesVery few studies have examined the quality of wedge resection in patients with non-small cell lung cancer. Using the National Cancer Database, we evaluated whether the quality of wedge resection affects overall survival in patients with early disease and how these outcomes compare with those of patients who receive stereotactic radiation.
methodsWe identified 14,328 patients with cT1 to T2, N0, M0 disease treated with wedge resection (n = 10,032) or stereotactic radiation (n = 4296) from 2005 to 2013 and developed a subsample of propensity-matched wedge and radiation patients. Wedge quality was grouped as high (negative margins, >5 nodes), average (negative margins, ≤5 nodes), and poor (positive margins). Overall survival was compared between patients who received wedge resection of different quality and those who received radiation, adjusting for demographic and clinical variables.
resultsAmong patients who underwent wedge resection, 94.6% had negative margins, 44.3% had 0 nodes examined, 17.1% had >5 examined, and 3.0% were nodally upstaged; 16.7% received a high-quality wedge, which was associated with a lower risk of death compared with average-quality resection (adjusted hazard ratio [aHR], 0.74; 95% confidence interval [CI], 0.67-0.82). Compared with stereotactic radiation, wedge patients with negative margins had significantly reduced hazard of death (>5 nodes: aHR, 0.50; 95% CI, 0.43-0.58; ≤5 nodes: aHR, 0.65; 95% CI, 0.60-0.70). There was no significant survival difference between margin-positive wedge and radiation.
conclusionsLymph nodes examined and margins obtained are important quality metrics in wedge resection. A high-quality wedge appears to confer a significant survival advantage over lower-quality wedge and stereotactic radiation. A margin-positive wedge appears to offer no benefit compared with radiation.
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