Long-Term Oncological Outcomes and Recurrence Patterns after Segmentectomy for Early-Stage Non-Small Cell Lung...

Area of Science:

• Thoracic surgery
• Surgical oncology
• Pulmonary medicine

Background:

• Anatomical segmentectomy is an alternative to lobectomy for early-stage non-small cell lung cancer (NSCLC).
• Long-term oncologic outcomes and recurrence patterns after segmentectomy require further evaluation.
• Identifying factors predicting recurrence and survival is crucial for patient selection and management.

Purpose of the Study:

• To assess long-term oncologic outcomes and recurrence patterns after anatomical segmentectomy in early-stage NSCLC.
• To identify preoperative and pathological factors associated with recurrence and survival in these patients.

Main Methods:

• Retrospective cohort study of 209 patients with clinical stage IA1-IA2 NSCLC undergoing anatomical segmentectomy.
• Kaplan-Meier method for recurrence-free survival (RFS) and overall survival (OS) estimation.
• Fine-Gray competing risks models and Cox regression for recurrence and mortality predictors.

Main Results:

• Five-year RFS and OS rates were 78.1% and 86.9%, respectively, with a median follow-up of 58.5 months.
• Recurrence occurred in 20.1% of patients (5.7% local, 8.6% regional, 5.2% distant).
• Tumor size, lingular resection, lymphovascular invasion, low diffusing capacity of the lung for carbon monoxide (DLCO), poor differentiation, pleural invasion, and higher neutrophil-to-lymphocyte ratio (NLR) were associated with recurrence or mortality.

Conclusions:

• Anatomical segmentectomy provides favorable long-term outcomes for selected early-stage NSCLC patients.
• Tumor characteristics (size, grade, invasion) and lingular location are key recurrence predictors.
• NLR may serve as a prognostic inflammatory biomarker; incorporating functional and inflammatory biomarkers can refine patient selection and surveillance.