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Segmentectomy versus lobectomy for small-sized pure solid non-small cell lung cancer.
Zhihua Li1, Wenzheng Xu1, Xianglong Pan1
1Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Thoracic Cancer
|March 7, 2023
Summary
Segmentectomy offers comparable long-term survival outcomes to lobectomy for pure solid non-small cell lung cancer (NSCLC). This finding suggests segmentectomy is a viable option for treating this specific type of lung cancer.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonology
Background:
- Segmentectomy is recommended for ground glass opacity (GGO)-dominant non-small cell lung cancer (NSCLC).
- Pure solid NSCLC has a poorer prognosis and its treatment with segmentectomy versus lobectomy remains debated.
- This study investigates the long-term outcomes of segmentectomy compared to lobectomy for pure solid NSCLC.
Purpose of the Study:
- To compare the oncological outcomes and long-term prognosis of segmentectomy and lobectomy in patients with pure solid small-sized NSCLC.
- To determine if segmentectomy provides comparable survival rates to lobectomy for this specific NSCLC subtype.
Main Methods:
- Retrospective screening of 344 pure solid NSCLC patients (≤2 cm) who underwent either segmentectomy or lobectomy.
- Utilized log-rank tests, univariable/multivariable Cox regression, and propensity score matching for prognostic comparison.
- Median follow-up time was 56 months.
Main Results:
- Segmentectomy patients (n=98) generally showed better unadjusted disease-free survival (DFS) and overall survival (OS) than lobectomy patients (n=246).
- Multivariable analysis and propensity score matched analysis (n=74 each) revealed no significant difference in DFS or OS between segmentectomy and lobectomy.
- Lobectomy group had larger tumors and higher rates of lymph node metastasis.
Conclusions:
- Segmentectomy achieves comparable oncological outcomes to lobectomy for pure solid small-sized NSCLC.
- Segmentectomy is a suitable alternative to lobectomy for selected patients with pure solid NSCLC, offering similar long-term survival benefits.
- Surgical approach (segmentectomy vs. lobectomy) does not significantly impact survival for pure solid NSCLC after adjusting for confounding factors.
