Left Upper Lobectomy vs Trisegmentectomy for Lung Cancer: A Propensity Score-Matched Comparison

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• The left upper division of the lung comprises segments I-III.
• Left upper lobectomy (LUL) is frequently used for tumors in this region, while left upper trisegmentectomy (LU3S) is less common.
• This study compares the safety and efficacy of LUL versus LU3S.

Purpose of the Study:

• To compare the short- and long-term outcomes of LUL and LU3S for non-small cell lung cancer (NSCLC) in the left upper division.
• To assess the safety and oncologic efficacy of both surgical procedures.

Main Methods:

• Retrospective review of patients with clinical stage IA-IIA NSCLC in the left upper division undergoing LUL or LU3S (January 2006-December 2020).
• Propensity score matching was employed to balance baseline characteristics between the two groups.
• Outcomes including postoperative complications, survival, and recurrence rates were analyzed.

Main Results:

• After matching, 83 patients were in each group (LUL vs. LU3S).
• No significant differences were observed in tumor size, lymph node sampling, or N2 nodal involvement.
• Postoperative complication rates (OR 0.75, 95% CI 0.39-1.46) and 30-day mortality were similar. Five-year overall survival (75.9% vs. 82.1%) and locoregional recurrence-free survival (73.7% vs. 80.0%) showed no statistically significant differences.

Conclusions:

• Left upper trisegmentectomy (LU3S) and left upper lobectomy (LUL) yield equivalent short- and long-term outcomes.
• Both procedures are safe and oncologically effective for selected patients with early-stage NSCLC in the left upper division.