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Lobectomy vs. segmentectomy. A propensity score matched comparison of outcomes
M Roman1, S Labbouz1, V Valtzoglou1
1Department of Thoracic Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
Segmentectomy offers similar short-term survival and oncological outcomes compared to lobectomy for non-small cell lung cancer (NSCLC). However, long-term survival significantly decreases in the segmentectomy group after four years.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Segmentectomy is an alternative to lobectomy for non-small cell lung cancer (NSCLC).
- This study investigates if segmentectomy offers comparable outcomes to lobectomy.
Purpose of the Study:
- To compare functional, oncological, and survival outcomes of segmentectomy versus lobectomy in NSCLC patients.
- To evaluate the long-term efficacy of parenchymal-sparing surgery.
Main Methods:
- Propensity score matching of 64 segmentectomy and 64 lobectomy cases.
- Comparison of survival using Kaplan Meier curves.
- Assessment of oncological and functional variables using Fischer exact test and t-test.
Main Results:
- Tumor size was smaller in the segmentectomy group (24.6 mm vs. 32.4 mm).
- Loco-regional recurrence was lower in segmentectomy (1.5% vs. 3.1%).
- 1-year survival was similar (92% vs. 88%), but 4-5 year survival was significantly lower for segmentectomy (39% vs. 68%).
Conclusions:
- Segmentectomy shows similar short-term outcomes but reduced long-term survival compared to lobectomy in NSCLC.
- Potential surgical selection bias may influence outcomes.
- Further investigation is needed for stage II/IIIa NSCLC treated with segmentectomy.
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