Risk Factors for Locoregional Relapse After Segmentectomy: Supplementary Analysis of the JCOG0802/WJOG4607L Trial

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonology

Background:

• Segmentectomy demonstrates superior overall survival compared to lobectomy for small-peripheral non-small cell lung cancer (NSCLC).
• Locoregional relapse (LR) remains a significant concern following segmentectomy for NSCLC.
• This study investigates risk factors for LR and segmentectomy's advantages based on primary tumor sites.

Purpose of the Study:

• To identify risk factors associated with locoregional relapse (LR) after segmentectomy in NSCLC patients.
• To evaluate the impact of primary tumor site on LR risk in segmentectomy.
• To provide insights for improving surgical strategies and reducing recurrence after segmentectomy.

Main Methods:

• Analysis of data from a multi-institutional, open-label, phase 3 randomized controlled trial in Japan.
• Investigation of risk factors for LR and clinical features related to primary tumor site in patients undergoing segmentectomy.
• Multivariable analysis to determine significant predictors of LR.

Main Results:

• Pure-solid appearance on thin-section computed tomography (CT), margin distance less than tumor size, and male sex were significantly associated with increased LR risk.
• Patients with left lingular segment tumors showed a trend towards higher LR compared to left upper division tumors.
• Tumor characteristics and margin distance are critical factors influencing LR after segmentectomy.

Conclusions:

• Thin-section CT findings are crucial for assessing LR risk in segmentectomy.
• Adequate margin distance is a vital factor in preventing locoregional relapse after segmentectomy.
• Surgical planning should consider tumor appearance and margin distance to minimize LR in segmentectomy for NSCLC.