Video-Assisted Surgery in Treating Patients With Non-small Cell Lung Cancer

OBJECTIVES: I. Determine the feasibility of performing video-assisted thoracic surgery
(VATS) lobectomy, without significant morbidity or perioperative mortality, in patients with
small (no greater than 3.0 cm), peripheral, non-small cell lung cancer. II. Determine the
rate at which a thoracotomy must be carried out to complete a VATS lobectomy in these
patients. III. Describe the complications associated with this procedure. IV. Describe the
length of the operative procedure, duration of chest tube stay, and length of
hospitalization in this patient population. V. Describe the survival and failure-free
survival, over a 5-year period, in this patient population following this procedure.

OUTLINE: Patients undergo video-assisted thoracic surgery (VATS) lobectomy, which requires 3
small incisions on the side of the chest. The entire anatomic pulmonary lobe is removed, as
well as all peribronchial lymph nodes and anterior hilar lymph nodes. If it is not possible
to remove the lobe using the VATS approach, then 1 of the incisions is converted to a
standard thoracotomy. Patients are followed every 4 months for the first 2 years, and then
every 6 months for the next 3 years.

PROJECTED ACCRUAL: A total of 135 patients will be accrued for this study within 3 years.

DISEASE CHARACTERISTICS: Suspected or histologically documented non-small cell lung cancer
Solitary, peripheral lung lesion that is no greater than 3.0 cm No metastatic disease No
positive lymph nodes at mediastinoscopy At least 5 years since diagnosis of non-small cell
or small cell lung cancer

PATIENT CHARACTERISTICS: Age: Not specified Performance status: ECOG 0-2 Life expectancy:
Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified
Pulmonary: FEV1 at least 1.0 L or at least 50% of predicted Other: No significant comorbid
medical or psychiatric condition No other active malignancy other than nonmelanomatous
skin cancer

PRIOR CONCURRENT THERAPY: Not specified