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Comparable Clinical Outcomes Between Segmentectomy and Lobectomy for NSCLC With Unsuspected N1/N2: A Multicenter
Tsuyoshi Ryuko1, Mikio Okazaki1, Toshiharu Mitsuhashi2
1Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; Okayama University Thoracic Surgery Study Group, Okayama, Japan.
For lung cancer patients with unexpected N1 or N2 lymph node metastasis, segmentectomy showed similar survival outcomes to lobectomy. However, segmentectomy was associated with a higher rate of local recurrence, suggesting careful consideration is needed.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Segmentectomy is increasingly used for lung cancer.
- Limited evidence exists on the need for further resection after unsuspected N1/N2 lymph node metastasis diagnosis.
Purpose of the Study:
- To compare segmentectomy versus lobectomy in non-small cell lung cancer (NSCLC) patients with unexpected N1 or N2 lymph node metastasis.
Main Methods:
- Multicenter, real-world data study of NSCLC patients (2012-2021) undergoing lobectomy or segmentectomy.
- Analysis of overall survival (OS), recurrence-free survival (RFS), and recurrence patterns using propensity score-adjusted cohorts.
Main Results:
- Segmentectomy group had a higher rate of local recurrence in propensity score-adjusted analysis.
- No significant differences in OS or RFS were observed between segmentectomy and lobectomy after propensity score adjustment.
Conclusions:
- Additional resection may not be necessary for NSCLC patients with unsuspected N1/N2 metastasis after segmentectomy.
- Higher local recurrence rates with segmentectomy warrant careful consideration and monitoring.
