Lobectomy versus segmentectomy in patients with stage T (> 2 cm and ≤ 3 cm) N0M0 non-small cell lung cancer: a propensity score matching study - Journal of Cardiothoracic Surgery
Source : https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-022-01867-x
Background The safety and effectiveness of lung segmentectomy in patients with early non-small cell lung cancer (NSCLC) remains controversial. We have therefore reviewed the clinicopathologic characteristics and survival outcomes of patients treated with lobectomy or segmentectomy for early T (> 2 and ≤ 3 cm) N0M0 NSCLC.
Conclusions: Patients with stage T (> 2 and ≤ 3 cm) N0M0 NSCLC undergoing segmentectomy can obtain OS and LCSS similar to those obtained with lobectomy. Further studies are required considering the solid component effects and pathologic tumor types regarding segmentectomies. Additional long-term survival and outcome analyses should be conducted with larger cohorts.
• Source: Journal of Cardiothoracic Surgery
• Conclusions: “Patients with stage T (> 2 and ≤ 3 cm) N0M0 NSCLC undergoing segmentectomy can obtain OS and LCSS [lung cancer-specific survival] similar to those obtained with lobectomy. Further studies are required considering the solid component effects and pathologic tumor types regarding segmentectomies. Additional long-term survival and outcome analyses should be conducted with larger cohorts.”
• In this population-based study mining the Surveillance, Epidemiology, and End Results (SEER) database, Chinese researchers assessed the clinical characteristics and prognoses of patients with T (> 2 and ≤ 3 cm) N0M0 NSCLC who were administered either segmentectomy or lobectomy.
• Before matching, the findings suggested that patients who underwent lobectomy exhibited better OS (P < ) and LCSS (P = ) vs segmentectomy. After matching, however, survival differences between the groups were nonsignificant: OS (P = 0.434) and LCSS (P = 0.593). On regression analysis, age and tumor grade were independently correlated with OS and LCSS (P < 0.05).
• Limitations of the current study include a paucity of patient details/outcomes; the grouping of unknown variables, which may result in bias; no information in the SEER database on imaging, smoking history, tumor markers, and so forth.
• “For a single lung segment resected after segmentectomy, the loss of lung function is twice that after lobectomy,” wrote the authors. “However, for multiple pulmonary nodules, segmentectomy can potentially reduce the loss of lung function even further …. for multiple primary lung cancer types, segmentectomy is recommended, and lung resection should be avoided; segmentectomy can also allow the performance of future lobectomies. Therefore, compared with lobectomy, segmentectomy could have more advantages for the retention of lung function over the short-term.
• Researchers could not compare the differences in lung function with regard to long-term survival after lobectomy vs. segmentectomy due to limitations in the SEER database