Minimally invasive segmentectomy for early stage lung cancer gains momentum

The extent of surgical resection for peripheral clinical T1N0M0 non-small cell lung cancer (NSCLC) ≤2 cm continues to be a matter of debate. In 1995, results from ‘The lung cancer study group’ trial established lobectomy as the standard of care. Since then, an extensive body of literature mainly composed of retrospective studies supports the use of radical anatomical segmentectomy, certainly for older patients with limited cardiopulmonary function. In a select group of patients, segmentectomy has been shown to be oncologically equivalent to lobectomy and it offers better preservation of pulmonary function (1,2). Paralleled with advancements in various diagnostic modalities, the understanding of segmental anatomy of pulmonary arteries, veins and bronchi continues to improve. Moreover, the risk of developing metachronous, recurrent or second primary lung cancer after therapeutic lung cancer resection surgery remains significant. Hence, patients with preserved lung function are more likely to withstand further therapeutic lung cancer surgery.