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Segmentectomy vs Lobectomy for Non-Small Cell Lung Cancer: The Impact of Tumor Location.
Segmentectomy vs Lobectomy for Non-Small Cell Lung Cancer: The Impact of Tumor Location. Annals of thoracic surgery short reports Wong, L. Y., Kapula, N., Elliott, I. A., Liou, D. Z., Backhus, L. M., Lui, N. S., Shrager, J. B., Berry, M. F. 2024; 2 (3): 458-463Abstract
The technical complexity of segmentectomy and preservation of lung parenchyma compared with lobectomy vary by lobe. This study evaluated the impact of non-small cell lung cancer tumor location on segmentectomy use and outcomes.Outcomes after lobectomy or segmentectomy for cT1N0M0 (=2 cm) non-small cell lung cancer patients stratified by tumor location in smaller (right upper/middle) vs larger (bilateral lower/left upper) lobes were evaluated with logistic regression, Kaplan-Meier curves, and Cox proportional hazards methods.A minority of patients in the cohort (N = 31,243) underwent segmentectomy (n = 2783, 9%). Segmentectomy was more common for tumors in larger compared with smaller lobes (11.8% vs 5.1%, P < .001). Major morbidity after segmentectomy was significantly lower than lobectomy for both smaller (2.6% vs 5.7%, odds ratio, 0.41, P < .001) and larger (2.5% vs 5.2%, odds ratio, 0.46, P < .001) lobes. Segmentectomy was associated with smaller lymph node harvest for both types of lobes (small lobes 7.0 vs 10.5, P < .001; large lobes 7.5 vs 10.4, P < .001) but did not compromise survival in multivariate analysis for both small (hazard ratio, 0.99, P = .9) and large (hazard ratio, 1.05, P = .34) lobes.Segmentectomy that does not compromise oncologic principles should be considered if complete resection is feasible regardless of tumor location.
View details for DOI 10.1016/j.atssr.2024.01.014
View details for PubMedID 39790437
View details for PubMedCentralID PMC11708542