Segmentectomy for cancer control in radiologically pure-solid clinical stage IA3 lung cancer.

Lobectomy Non-small-cell lung cancer Pure-solid Recurrence Segmentectomy

Journal

Interdisciplinary cardiovascular and thoracic surgery
ISSN: 2753-670X
Titre abrégé: Interdiscip Cardiovasc Thorac Surg
Pays: England
ID NLM: 9918540787006676

Informations de publication

Date de publication:
02 Sep 2023
Historique:
received: 20 04 2023
revised: 10 07 2023
accepted: 16 08 2023
medline: 17 8 2023
pubmed: 17 8 2023
entrez: 17 8 2023
Statut: ppublish

Résumé

This study aimed to compare cancer control after segmentectomy and lobectomy in patients with radiologically pure-solid clinical stage IA3 non-small-cell lung cancer (NSCLC). Patients with radiologically pure-solid clinical stage IA3 NSCLC who underwent lobectomy or segmentectomy at 3 institutions between 2010 and 2019 were identified. We estimated propensity scores to adjust for confounding variables regarding tumour malignancy, including age, sex, smoking history, tumour size, maximum standardized uptake value on 18F-fluorodeoxyglucose positron emission tomography, lymph node dissection, histological type and lymphatic, vascular and pleural invasion. Cumulative incidence of recurrence (CIR) was evaluated as a primary end point. Among 412 patients, postoperative recurrence occurred in 7 of 44 patients (15.9%) undergoing segmentectomy, and 71 of 368 patients (19.3%) undergoing lobectomy. CIR was comparable between patients undergoing segmentectomy (5-year rate, 21.9%) and those undergoing lobectomy (5-year rate, 20.8%; P = 0.88). Locoregional recurrence did not differ between patients undergoing segmentectomy (6.8%) and those undergoing lobectomy (9.0%). In multivariable analysis, segmentectomy (versus lobectomy) was not identified as an independent prognostic factor for CIR (hazard ratio, 1.045; 95% confidence interval, 0.475-2.298; P = 0.91). In propensity score matching of 40 pairs, CIR was not significantly different between patients undergoing segmentectomy (5-year rate, 20.7%) and those undergoing lobectomy (5-year rate, 18.4%; P = 0.81). Cancer control may be comparable between segmentectomy and lobectomy in patients with radiologically pure-solid clinical stage IA3 NSCLC. Further studies are warranted to clarify the survival benefits of segmentectomy in these patients.

Identifiants

pubmed: 37589650
pii: 7244022
doi: 10.1093/icvts/ivad138
pmc: PMC10533752
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

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Auteurs

Atsushi Kamigaichi (A)

Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.

Takahiro Mimae (T)

Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.

Norifumi Tsubokawa (N)

Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.

Yoshihiro Miyata (Y)

Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.

Hiroyuki Adachi (H)

Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.

Yoshihisa Shimada (Y)

Department of Surgery, Tokyo Medical University, Tokyo, Japan.

Hiroyuki Ito (H)

Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.

Norihiko Ikeda (N)

Department of Surgery, Tokyo Medical University, Tokyo, Japan.

Morihito Okada (M)

Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.

Classifications MeSH