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Does anatomical segmentectomy allow an adequate lymph node staging for cT1a non-small cell lung cancer?
Sandro Mattioli1, Alberto Ruffato, Francesco Puma
1Division of Thoracic Surgery, GVM Care and Research, Maria Cecilia Hospital Cotignola (Ra), Alma Mater Studiorum-University of Bologna, Bologna, Italy. sandro.mattioli@unibo.it
Summary
Anatomical segmentectomy provides adequate lymph node resection for early-stage lung cancer, matching lobectomy outcomes. This lung cancer surgery offers equivalent survival and recurrence-free rates.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Anatomical segmentectomy is being re-evaluated for treating T1a N0 non-small cell lung cancer and carcinoid tumors.
- The adequacy of lymph node resection for staging and cure via anatomical segmentectomy remains under investigation.
Purpose of the Study:
- To compare the adequacy of lymph node dissection and oncological outcomes between anatomical segmentectomy and lobectomy for T1a N0 non-small cell lung cancer.
Main Methods:
- A case-matched study compared patients with peripheral cT1a N0 M0 tumors undergoing anatomical segmentectomy or lobectomy.
- Lymph node stations 4, 5, 6, 7, 10, 11, 12, and 13 were dissected in both groups.
Main Results:
- Matched cohorts (46 each) showed no significant difference in tumor size (1.7 cm vs. 1.6 cm).
- Resection margins were clear in both groups. Dissected lymph nodes (total, N1, N2) and N1 positivity rates were similar between anatomical segmentectomy and lobectomy.
- 36-month recurrence-free survival was 100% for anatomical segmentectomy versus 93.5% for lobectomy.
Conclusions:
- Anatomical segmentectomy for cT1a tumors yields an adequate number of N1 and N2 lymph nodes for pathological examination.
- Cancer-specific survival at 36 months was equivalent between anatomical segmentectomy and lobectomy.
