Isolated surgical margin recurrence after segmentectomy for non-small cell lung cancer

We retrospectively reviewed patients undergoing segmentectomy for clinical stage I non-small cell lung cancer at two institutions in 2007-2015 who developed isolated margin recurrence. Among 240 segmentectomies, 17 patients developed margin recurrence; 16 received treatment. All underwent fluorodeoxyglucose positron emission tomography/computed tomography; 13 had histological confirmation. Treatments comprised re-resection (n = 7), radiotherapy (n = 5), photodynamic therapy (n = 1), and epidermal growth factor receptor tyrosine kinase inhibitors alone (n = 3). Re-resection resulted in one complication and no 90-day deaths. During a median follow-up of 53 months, subsequent progression occurred in none after re-resection, three after nonsurgical local therapy, and two after targeted therapy; five patients died. This series describes local and systemic treatment pathways. Although comparative efficacy could not be assessed, favorable local control was observed after re-resection in this selected cohort.