Video-Assisted Thoracoscopic Segmentectomy for Deep and Peripheral Small Lung Cancer

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonology

Background:

• Nonsmall cell lung cancer (NSCLC) management often involves segmentectomy for small tumors.
• The impact of deep versus peripheral tumor location on outcomes after segmentectomy is not well-defined.

Purpose of the Study:

• To compare long-term prognosis and recurrence rates after segmentectomy in NSCLC patients with deep versus peripheral lesions.
• To evaluate the influence of tumor location on survival outcomes following video-assisted thoracoscopic segmentectomy.

Main Methods:

• Retrospective analysis of 85 NSCLC patients undergoing video-assisted thoracoscopic segmentectomy with curative intent.
• Tumor location (deep vs. peripheral) determined by 3D CT.
• Comparison of overall and recurrence-free survival using univariate and multivariate Cox models.

Main Results:

• No recurrences were observed in either deep or peripheral lesion groups.
• 5-year overall survival was high (96.4% overall, 100% deep, 95.3% peripheral) with no significant difference between groups (p=0.189).
• American Society of Anesthesiologists score and histology were independent prognostic factors; tumor location was not.

Conclusions:

• Tumor location does not affect recurrence risk or prognosis in small NSCLC treated with segmentectomy.
• Video-assisted thoracoscopic segmentectomy is an acceptable procedure for small NSCLC, irrespective of tumor location, when performed with adequate margins.