Hot Topic In Thoracic Surgery: Can Sublobar Anatomical Resections Be Non-Inferior To Lobectomies For Small,...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonology

Background:

• Advancements in screening detect smaller lung lesions, shifting focus to lung-sparing surgical procedures.
• The efficacy of limited surgical excision for small peripheral lung nodules is under active investigation.
• Current debates question the role of segmentectomy versus lobectomy for early-stage non-small cell lung cancer (NSCLC).

Purpose of the Study:

• To evaluate the adequacy of segmentectomy for treating peripheral non-small cell lung cancer (NSCLC) staged as Tis/1a-bN0M0.
• To compare disease-free survival and relapse rates between segmentectomy and lobectomy for early-stage NSCLC.
• To assess the potential of segmentectomy as a lung-sparing alternative in NSCLC treatment.

Main Methods:

• Single-center retrospective study analyzing 8 years of surgical experience.
• Matched-pair analysis comparing 16 segmentectomy patients with 16 lobectomy patients based on age, lesion size, and follow-up duration.
• Inclusion criteria: NSCLC histology, lesions ≤2 cm, no visceral pleura invasion, N0 disease, surgery between Jan 2015 and Dec 2022.

Main Results:

• The study included 32 patients (16 segmentectomies, 16 lobectomies) with a mean follow-up of 30-32 months.
• Disease-free survival was 27 months for segmentectomy and 31 months for lobectomy.
• Relapse rates were 19% for segmentectomy and 12.5% for lobectomy.

Conclusions:

• Segmentectomy shows promise as a lung-sparing procedure for select early-stage peripheral NSCLC.
• Further research with larger cohorts is necessary to confirm the non-inferiority of segmentectomy.
• Segmentectomy offers benefits like lung preservation and potential for future interventions.