Comparison of cancer control between segmentectomy and wedge resection in patients with clinical stage IA non–small cell lung cancer

Tsutani, Yasuhiro; Handa, Yoshinori; Shimada, Yoshihisa; Ito, Hiroyuki; Ikeda, Norihiko; Nakayama, Haruhiko; Yoshimura, Kenichi

doi:10.1016/j.jtcvs.2020.10.024

Cited by 35 publications

(22 citation statements)

References 21 publications

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“…In the study of Tsutani et al, postoperative recurrence occurred in 36 of 195 patients (18.5%) undergoing wedge resection and 14 of 262 patients (5.3%) undergoing segmentectomy. Cancer control was better in segmentectomy than in wedge resection [ 20 ]. Suzuki et al reported that Median pathological surgical margin was 15 mm (0–55) and the 5-year relapse-free survival was 99.7% (90% confidence interval, 98.3–99.9).…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgical outcomes and prognosis between wedge resection and simple Segmentectomy for GGO diameter between 2 cm and 3 cm in non-small cell lung cancer: a multicenter and propensity score matching analysis

Zhou

Zhang

et al. 2022

BMC Cancer

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Background As segmentectomy had become commonly used for Non-Small Cell Lung Cancer (NSCLC) treatment, which had the advantages of radical operation, however, it remains controversial owing to procedural complexity and risk of increased complications compared with wedge resection. We evaluated operative and postoperative outcomes of simple segmentectomy compared to wedge resection in ground-glass opacity (GGO) diameter between 2 cm and 3 cm NSCLC. Methods We retrospectively reviewed 1600 clinical GGO diameter between 2 cm and 3 cm NSCLC patients who received simple segmentectomy and wedge resection between Jan 2011 and Jan 2015. Participants were matched 1:1 on their propensity score for two groups. Clinic-pathologic, operative, and postoperative results of two groups were compared. Results After using propensity score methods to create a matched cohort of participants with simple segmentectomy group similar to that wedge resection, there were no significant differences detected in tumor size, margin distance, histology, age, sex, preoperative comorbidities and preoperative pulmonary function. Overall complications in simple segmentectomy group were more than wedge resection group (21% vs 3%, p = 0.03). Median operative time (110.6 vs. 71.2 min; p = 0.01) and prolonged air leakage (12% vs. 3%; p = 0.02) was significantly longer in the simple segmentectomy group. There was no difference in recurrence free survival (RFS) and overall survival (OS) of 5-years between simple segmentectomy group and wedge resection group. Postoperative pulmonary function in simple segmentectomy group recovered more slowly than wedge resection group. Conclusion Wedge resection may have comparable efficacy as simple segmentectomy for GGO diameter between 2 cm and 3 cm NSCLC, but lead to less complications, less surgical procedure and faster recovery of pulmonary function.

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Section: Discussionmentioning

confidence: 99%

Comparison of surgical outcomes and prognosis between wedge resection and simple Segmentectomy for GGO diameter between 2 cm and 3 cm in non-small cell lung cancer: a multicenter and propensity score matching analysis

Zhou

Zhang

et al. 2022

BMC Cancer

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“…Segmentectomy and wedge resection are two types of sublobar resection; the biggest difference between these two methods is that segmentectomy requires the oncology standard of lobectomy, such as the anatomy of the separation of pulmonary segment veins, arteries, and bronchi, and the better removal of lung parenchymal tissue. However, the choice between wedge resection and segmentectomy as the superior sublobar resection method in NSCLC patients with tumors ≤ 2 cm remains contentious due to the contradictory results [10][11][12][13]. Therefore, selecting the optimal extent of resection in terms of the potential long-term outcome and the risk of perioperative complications and death is difficult for surgeons, indicating that the optimal sublobar resection strategy for early-stage NSCLC patients is essential.…”

Section: Introductionmentioning

confidence: 99%

Lobe-Specific Analysis of Sublobar Lung Resection for NSCLC Patients with Tumors ≤ 2 cm

Lei

Zhou

Zhang

et al. 2022

Cancers

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(1) Background: Sublobar resection can be used as an alternative surgical strategy for early-stage non-small-cell lung cancer (NSCLC) patients. However, the choice between wedge resection and segmentectomy remains contentious. In this study, we investigated the optimal surgical procedure for sublobar resection in patients with NSCLC ≤ 2 cm with a lobe-specific analysis; (2) Methods: Data for patients with T1N0M0 with a diameter of ≤2 cm who had undergone sublobar resection were retrieved. Propensity score matching (PSM) was used to reduce the inherent bias, and the Kaplan–Meier method and log-rank tests were used to assess the differences in survival; (3) Results: A total of 1882 patients were identified after the PSM. Patients with NSCLC ≤ 2 cm who had undergone segmentectomy showed better survival than those who had undergone wedge resection. However, when NSCLC was ≤1 cm, there was no significant difference in OS between the two groups. This demonstrated an OS advantage of segmentectomy over wedge resection for patients with NSCLC tumors of 1–2 cm (p = 0.024). Further analysis indicated that this survival benefit was only observed in patients with right upper NSCLC of 1–2 cm, but not with NSCLC in the other four lobes; (4) Conclusions: Segmentectomy showed a greater survival benefit than wedge resection only in patients with NSCLC of 1–2 cm, particularly those with primary tumors in the right upper lobe. Therefore, we propose a lobe-specific sublobar resection strategy for early-stage NSCLC patients (tumors of 1–2 cm) who cannot tolerate lobectomy.

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“…In the 2000s, several researchers found that segmentectomy for small-sized stage I lung cancers can yield outcomes equivalent to those of lobectomy even in patients who are fit for lobectomy [2][3][4]. In addition, oncologic outcomes of segmentectomy were reported to be superior than those of wedge resection [5,6]. Therefore, segmentectomy has been becoming the optional treatment for NSCLC and has been chosen more frequently.…”

Section: Introductionmentioning

confidence: 99%

Techniques of Minimally Invasive Posterior Basal (S10) Segmentectomies of the Lower Lobes

Tsutani

Okada

2022

Operative Techniques in Thoracic and Cardiovascular Surgery

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Comparison of cancer control between segmentectomy and wedge resection in patients with clinical stage IA non–small cell lung cancer

Cited by 35 publications

References 21 publications

Comparison of surgical outcomes and prognosis between wedge resection and simple Segmentectomy for GGO diameter between 2 cm and 3 cm in non-small cell lung cancer: a multicenter and propensity score matching analysis

Comparison of surgical outcomes and prognosis between wedge resection and simple Segmentectomy for GGO diameter between 2 cm and 3 cm in non-small cell lung cancer: a multicenter and propensity score matching analysis

Lobe-Specific Analysis of Sublobar Lung Resection for NSCLC Patients with Tumors ≤ 2 cm

Techniques of Minimally Invasive Posterior Basal (S10) Segmentectomies of the Lower Lobes

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