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Oncologic Outcomes of Complex Segmentectomy: A Multicenter Propensity Score-Matched Analysis.
Yoshinori Handa1, Yasuhiro Tsutani1, Takahiro Mimae1
1Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
The Annals of Thoracic Surgery
|August 16, 2020
Summary
Complex segmentectomy offers comparable oncologic outcomes to lobectomy for early-stage lung cancer. This surgical approach provides similar long-term survival and recurrence-free rates, establishing its efficacy in lung cancer treatment.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonology
Background:
- Complex segmentectomy, a lung cancer surgical technique, involves intricate intersegmental planes.
- Its oncologic outcomes in lung cancer treatment are not yet fully established.
- Lobectomy is a standard surgical treatment for lung cancer.
Purpose of the Study:
- To compare the oncologic outcomes of complex segmentectomy versus lobectomy in patients with clinical stage I lung cancer.
- To evaluate the long-term survival and recurrence rates for both surgical procedures.
- To establish the efficacy of complex segmentectomy as a treatment option for lung cancer.
Main Methods:
- Retrospective analysis of 1517 patients with clinical stage I lung cancer (solid component size ≤ 2.0 cm) from 2010-2018.
- Comparison of complex segmentectomy (n=240) and location-adjusted lobectomy (n=851) outcomes.
- Propensity score-matched analysis was used to control for patient characteristics.
Main Results:
- No significant difference in 5-year cancer-specific survival (CSS) or recurrence-free interval (RFI) between complex segmentectomy and lobectomy in the overall cohort.
- Similar long-term outcomes (5-year CSS and RFI) were observed in 219 propensity score-matched pairs.
- Propensity score-adjusted analysis confirmed comparable prognosis between complex segmentectomy and lobectomy for RFI (HR=0.98).
Conclusions:
- Complex segmentectomy demonstrates acceptable oncologic outcomes for clinical stage I lung cancer.
- The study supports complex segmentectomy as a viable alternative to lobectomy, offering similar long-term results.
- Further research may solidify complex segmentectomy's role in lung cancer surgical guidelines.
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