Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study

Area of Science:

• Thoracic Surgery
• Surgical Oncology

Background:

• Segmentectomy is a parenchymal-sparing approach recommended for select early-stage non-small cell lung cancer (NSCLC) patients over lobectomy.
• Limited clinical guidance exists for segmentectomy regarding patient indication, surgical approaches, and lymph node assessment.

Purpose of the Study:

• To establish expert consensus on key aspects of segmentectomy for early-stage NSCLC.
• To provide guidance on patient selection, surgical techniques, and lymph node assessment for segmentectomy.

Main Methods:

• A modified Delphi approach involving 3 surveys and 2 expert discussions with 15 experienced Asian thoracic surgeons.
• Statements were developed based on clinical experience, literature review, and expert feedback.
• Consensus was defined as ≥70% agreement among 11 voting experts.

Main Results:

• Consensus was achieved on 36 statements covering patient indication (11), segmentectomy approaches (19), and lymph node assessment (6).
• Consensus rates increased across survey rounds, reaching 100% by round 3.
• The study highlights growing agreement on segmentectomy principles.

Conclusions:

• Expert consensus provides crucial guidance for thoracic surgeons considering segmentectomy in early-stage NSCLC.
• The findings support segmentectomy as a viable surgical option, emphasizing informed decision-making.
• This consensus aims to standardize and improve segmentectomy practices for improved patient outcomes.