Lobectomy vs Segmentectomy in Stage I Non-Small Cell Lung Cancer With Lymphatic Vascular Invasion.

Area of Science:

• Oncology
• Thoracic Surgery
• Cancer Research

Background:

• Non-small cell lung cancer (NSCLC) is the most common type of lung cancer.
• Lymphovascular invasion (LVI) is a negative prognostic factor in NSCLC.
• Treatment guidelines for NSCLC with LVI are lacking, particularly regarding surgical approach.

Purpose of the Study:

• To compare the survival and clinical characteristics of segmentectomy versus lobectomy in patients with stage I NSCLC and LVI.
• To evaluate the impact of surgical approach on disease-free survival in this patient population.

Main Methods:

• Retrospective cohort study utilizing the National Cancer Database (2004-2020).
• Propensity score matching was employed to control for patient and tumor characteristics.
• Statistical analyses included Kaplan-Meier survival analysis and Cox proportional hazards models.

Main Results:

• A total of 8028 patients were included; 94.8% underwent lobectomy and 5.2% underwent segmentectomy.
• After propensity score matching, no significant difference in median survival was observed between the segmentectomy and lobectomy groups.
• Multivariate analysis revealed no significant difference in hazard or odds of death between the two surgical groups.

Conclusions:

• Segmentectomy and lobectomy demonstrate comparable overall disease-free survival for stage I NSCLC patients with LVI.
• The findings suggest that segmentectomy may be a viable alternative to lobectomy in select patients with LVI.
• Further research may be warranted to explore patient selection criteria for each surgical approach.