Outcomes of superior segmentectomy versus lower lobectomy for superior segment Stage I non-small-cell lung cancer are equivalent: An analysis of 196 patients at a single, high volume institution.

Abstract

OBJECTIVES:

To determine if superior segmentectomy has equivalent overall (OS), disease-free (DFS), and locoregional-recurrence-free survival (LRFS) to lower lobectomy for early-stage non-small-cell lung cancer (NSCLC) in the superior segment.

METHODS:

We retrospectively reviewed all Stage 1 lower lobectomies for superior segment lesions and superior segmentectomies at our hospital from 2000 to 2018. Comparison statistics and Cox hazard modeling were performed to determine differences between groups and attempt to identify risk factors for OS, DFS, and LRFS.

RESULTS:

Superior segmentectomy patients, compared with lower lobectomy patients, had more current smokers, worse forced expiratory volume in 1 s percentage, radiologic emphysema scores, clinically and pathologically smaller tumors, and more occurrences of 0 lymph nodes examined. Outcomes for superior segmentectomy compared with lower lobectomy were equivalent for 5-year OS (67.0% vs. 75.1%, p = 0.70), DFS (56.9% vs. 60.4%, p = 0.59), and LRFS (87.9% vs. 91.3%, p = 0.46). Multivariable Cox modeling lacked utility due to no outcome differences.

CONCLUSIONS:

In well-selected patients, superior segmentectomies can have equivalent OS, DFS, and LRFS compared with lower lobectomies of superior segment tumors for early stage lung cancer. Further data are needed to provide better risk estimates.

• Authors: Daniel P Dolan, Abby White, Emanuele Mazzola, Daniel N Lee, Ritu Gill, Suden Kucukak, Raphael Bueno, Michael T Jaklitsch, Steven J Mentzer, Scott J Swanson
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 123 Issue 2 Pg. 570-578 (Feb 2021) ISSN: 1096-9098 [Electronic] United States
• PMID: 33259656 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2020 Wiley Periodicals LLC.

Topics

• Aged
• Carcinoma, Non-Small-Cell Lung (mortality, pathology, surgery)
• Female
• Follow-Up Studies
• Hospitals, High-Volume (statistics & numerical data)
• Humans
• Lung Neoplasms (mortality, pathology, surgery)
• Male
• Middle Aged
• Neoplasm Staging
• Pneumonectomy (classification, mortality)
• Retrospective Studies
• Survival Rate