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Lobectomy Versus Segmentectomy in Radiologically Pure Solid Small-Sized Non-Small Cell Lung Cancer
Terumoto Koike1, Akihiko Kitahara1, Seijiro Sato1
1Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
The Annals of Thoracic Surgery
|January 23, 2016
Summary
For small, solid non-small cell lung cancer (NSCLC), lobectomy and segmentectomy offer similar survival outcomes. This study found no significant differences in overall survival or disease-free survival between the two surgical approaches for NSCLC patients.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Limited resection for radiologically pure solid non-small cell lung cancer (NSCLC) is debated due to its invasive nature.
- Comparing outcomes of lobectomy versus segmentectomy in these specific NSCLC cases is crucial.
Purpose of the Study:
- To compare oncologic outcomes between lobectomy and segmentectomy in patients with radiologically pure solid NSCLC.
- To determine if surgical approach impacts overall survival (OS) and disease-free survival (DFS) in this patient cohort.
Main Methods:
- Retrospective review of 251 patients with clinical T1a N0 M0 NSCLC.
- Propensity score matching to compare lobectomy (87 patients) and segmentectomy (87 patients).
- Analysis of OS and DFS using log-rank and McNemar tests; multivariate Cox regression for predictor identification.
Main Results:
- No significant differences in 5- and 10-year OS and DFS rates between lobectomy and segmentectomy groups.
- Log-rank and McNemar tests showed no statistically significant survival disparities.
- Age, smoking status, pulmonary function, and CEA levels predicted survival; surgical procedure did not.
Conclusions:
- Lobectomy and segmentectomy yield similar oncologic outcomes for patients with radiologically pure solid, small-sized NSCLC.
- Surgical approach is not an independent predictor of survival in this NSCLC subgroup.
