Perioperative course and quality of life in a prospective randomized multicenter phase III trial, comparing standard lobectomy versus anatomical segmentectomy in patients with non-small cell lung cancer up to 2 cm, stage IA (7th edition of TNM staging system)

Stamatis, Georgios; Leschber, Gunda; Schwarz, Birte; Brintrup, Diana Lütke; Ose, Claudia; Weinreich, Gerhard; Passlick, Bernward; Hecker, Erich; Kügler, Christian; Dienemann, Hendrik; Krbek, Thomas; Eggeling, Stephan; Hatz, Rudolf; Müller, Michael; Weder, Walter; Aigner, Clemens; Jöckel, Karl‐Heinz

doi:10.1016/j.lungcan.2019.09.021

Cited by 58 publications

(42 citation statements)

References 36 publications

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“…We found no differences with regard to intra‐ or postoperative outcomes between both groups. This corroborates previous work by our group and other multicentric studies, which compared postoperative VS and VL complications rates 34–37 …”

Section: Discussionsupporting

confidence: 92%

Short‐term local control after VATS segmentectomy and lobectomy for solid NSCLC of less than 2 cm

et al. 2020

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Introduction VATS pulmonary segmentectomy is increasingly proposed as a parenchyma‐sparing resection for tumors smaller than 2 cm in diameter. The aim of this study was to compare short‐term oncological results and local control in solid non‐small cell lung cancers (NSCLCs) <2 cm surgically treated by intentional VATS segmentectomy or lobectomy. Methods This study was a single center retrospective study of consecutive patients undergoing VATS lobectomy (VL) or segmentectomy (VS) for solid <2 cm NSCLC from January 2014 to October 2019. Results In total, 188 patients with a median age of 65 years (male/female: 99/89) underwent VS (n = 96) or VL (n = 92). Segmentectomies in the upper lobes were performed in 57% and as a single segment in 55% of cases. There was no statistically significant difference between VS and VL in terms of demographics, comorbidities, postoperative outcomes, dissected lymph node stations (2.89 ± 0.95 vs. 2.93 ± 1, P = 0.58), rate of pN1 (2.2% vs. 2.1%, P = 0.96) or pN2 upstaging (1.09% vs. 1.06%, P = 0.98). Adjuvant chemotherapy was given in 15% of patients in the VL and 11% in the VS group. During follow‐up (median: 23 months), no patients presented with local nodal recurrence or on the stapler line (VS group). Three patients on VL and two in VS groups presented with recurrence on the remnant operated lung. New primary pulmonary tumors were diagnosed in 3.3% and 6.3% of patients in the VL and VS groups, respectively. Conclusions Despite the short follow‐up, our preliminary data shows that local control is comparable for VATS lobectomy and VATS segmentectomy for patients with NSCLC <2 cm.

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Section: Discussionsupporting

confidence: 92%

Short‐term local control after VATS segmentectomy and lobectomy for solid NSCLC of less than 2 cm

et al. 2020

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“…In summary, our study shown that segmentectomy and lobectomy have similar lung cancer-speci c survival or overall survival rates among patients with clinical stage I NSCLC. From a survival standpoint, as far as we know, large prospective randomized trials on standard lobectomy versus anatomical segmentectomy are on its way, while so far only results on perioperative outcome and quality of life of the European SevLoT1a trial have been published (29).Further RCTs into "personalized therapy" that will bene t patients by subtype, which can be instructive in driving treatment decisions, while conferring with acceptable adverse events.…”

Section: Resultsmentioning

confidence: 99%

Survival Outcomes of Lobectomy in Comparison With Segmentectomy in Clinical Stage I Non-small-cell Lung Cancer: a Meta-analysis

Feng¹,

Han²,

Wang³

et al. 2021

Preprint

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Background: The gold standard surgical therapy for patients with clinical stage I non-small-cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node dissection. While, segmentectomy has emerged as an alternative choice with the advantage of fewer postoperative complications. However, the acceptance of this procedure still remains controversial, and conflicting results exist in the retrospective trials.Objectives: The aim of this meta-analysis was to analysis the survival outcomes of lobectomy in comparison with segmentectomy in treatment of clinical stage I non-small-cell lung cancer. Methods: Computerized literature search was done on the published trials in Pubmed, Embase, Cochrane library databases to June, 2019 to identify clinical trials. Lung cancer-specific survival (LCSS) and overall survival (OS) were measured as outcomes. Statistical analysis was performed using the Meta-analysis Revman 5.3 software.Results: A systematic literature search was conducted including 7 studies. In this meta-analysis, results indicate that lobectomy confers an equivalent survival outcome compared with segmentectomy. Conclusion: No significant differences were found in survival outcomes between lobectomy and segmentectomy. Further prospective large-scale, prospective, randomized trials are needed to explore the reasonable surgical treatment for early resectable lung cancer.

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“…This was despite including wedge resections and segmentectomies in their sublobar resection group; 201 wedge resection patients and 139 lobectomy patients [31] . Stamatis et al [32] noted equal rates of prolonged air leak in their 53 segmentectomy patients compared to their 54 lobectomy patients. Until the long-term outcomes of these randomized control trials are evaluated, the choice of therapy should be determined by a multidisciplinary team.…”

Section: Therapeutic Choice For Optimal Long-term Outcomes Of High-risk Patientsmentioning

confidence: 94%

“…Unfortunately, even with all this data, the best option for high-risk patients who can undergo limited resection, but not full lobectomy, remains unclear. Three randomized control trials are ongoing comparing lobectomy to sublobar resection for early stage NSCLC, ≤ 2 cm with N0 lymph node status [30][31][32] . All three studies have reported their peri-operative safety results and found no substantial differences.…”

Section: Therapeutic Choice For Optimal Long-term Outcomes Of High-risk Patientsmentioning

confidence: 99%

Sublobar resection in high-risk patients for lobectomy: current and future strategy

Dolan¹,

Swanson²

2021

Mini-invasive Surg

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Surgical resection by lobectomy is the gold standard of therapy for early stage non-small cell lung cancer. However, not all patients are medically fit to undergo surgery. In patients considered high-risk for lobectomy, alternative strategies have been developed including radiofrequency ablation, cryoablation, microwave ablation, stereotactic radiation therapy, wedge resection, and segmentectomy. This work reviews the definition of high-risk, and the outcomes that have been associated with each treatment technique. Some technical points regarding wedge resection versus segmentectomy are noted. Future directions are discussed in the context of treatment for patients considered at high-risk for lobectomy.

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Perioperative course and quality of life in a prospective randomized multicenter phase III trial, comparing standard lobectomy versus anatomical segmentectomy in patients with non-small cell lung cancer up to 2 cm, stage IA (7th edition of TNM staging system)

Cited by 58 publications

References 36 publications

Short‐term local control after VATS segmentectomy and lobectomy for solid NSCLC of less than 2 cm

Short‐term local control after VATS segmentectomy and lobectomy for solid NSCLC of less than 2 cm

Survival Outcomes of Lobectomy in Comparison With Segmentectomy in Clinical Stage I Non-small-cell Lung Cancer: a Meta-analysis

Sublobar resection in high-risk patients for lobectomy: current and future strategy

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Perioperative course and quality of life in a prospective randomized multicenter phase III trial, comparing standard lobectomy versus anatomical segmentectomy in patients with non-small cell lung cancer up to 2 cm, stage IA (7th edition of TNM staging system)

Cited by 58 publications

References 36 publications

Short‐term local control after VATS segmentectomy and lobectomy for solid NSCLC of less than 2 cm

Short‐term local control after VATS segmentectomy and lobectomy for solid NSCLC of less than 2 cm

Survival Outcomes of Lobectomy in Comparison With Segmentectomy in Clinical Stage I Non-small-cell Lung Cancer: a Meta-analysis

Sublobar resection in high-risk patients for lobectomy: current and future strategy

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Perioperative course and quality of life in a prospective randomized multicenter phase III trial, comparing standard lobectomy versus anatomical segmentectomy in patients with non-small cell lung cancer up to 2 cm, stage IA (7th edition of TNM staging system)