Prognostic comparison between superior and basal segments in pure-solid non-small cell lung cancer

Area of Science:

• Thoracic Surgery
• Oncology
• Pulmonary Medicine

Background:

• Non-small cell lung cancer (NSCLC) in the superior segment (S6) may impact lymphatic drainage differently than basal segment tumors.
• Pure-solid NSCLC subtypes exhibit higher rates of lymph node metastasis and poorer prognoses.

Purpose of the Study:

• To compare survival outcomes between S6 and basal segment pure-solid NSCLC after lobectomy.
• To investigate the prognostic impact of tumor location within the lower lobe for pure-solid NSCLC.

Main Methods:

• Retrospective review of 157 patients with pure-solid, clinical N0 M0, ≤5-cm lower-lobe NSCLC.
• Patients underwent lobectomy with hilar and mediastinal lymphadenectomy.
• Analysis of overall survival, recurrence-free survival, and clinicopathological characteristics.

Main Results:

• No significant differences in 5-year overall survival (66.4% vs. 68.6%) or recurrence-free survival (54.8% vs. 65.5%) between S6 and basal segment groups.
• Tumor location was not a significant predictor of survival in multivariable analysis.
• S6 tumors showed a higher incidence of visceral pleural invasion; superior mediastinal lymph node metastasis occurred exclusively in two S6 cases.

Conclusions:

• Lobectomy with lymphadenectomy yields comparable survival for pure-solid NSCLC in S6 and basal segments.
• Tumor location within the lower lobe does not significantly affect survival for this specific NSCLC subtype.
• While S6 tumors may have a higher risk of visceral pleural invasion, survival outcomes remain similar post-surgical resection.