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Rebuttal From Dr DetterbeckRebuttal from Dr Detterbeck

Frank C. Detterbeck, MD, FCCP
Author and Funding Information

Department of Surgery, Division of Thoracic Surgery, Yale University School of Medicine.

Correspondence to: Frank C. Detterbeck, MD, FCCP, Yale University School of Medicine, Thoracic Surgery, 330 Cedar St, BB205, New Haven, CT 06520-8062; e-mail: Frank.detterbeck@yale.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(3):593-594. doi:10.1378/chest.11-3111
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Extract

The main arguments Dr Donington1 makes in favor of limited resection are that the current nature of non-small cell lung cancer (NSCLC) differs from the Lung Cancer Study Group era (and now includes subgroups for whom limited resection is best) and that modern recurrence and survival rates after sublobar resection are good, comparable to traditional data following lobectomy. I certainly agree that the spectrum of NSCLC currently includes more patients with less aggressive and relatively indolent tumors, and I agree that more limited treatment (ie, sublobar resection, stereotactic body radiotherapy, radiofrequency ablation) or even observation might sometimes be appropriate. I only disagree that we have defined either the patient selection or the treatment well enough. We certainly have not defined them well enough to recommend limited resection as a general approach for stage I NSCLC.

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