Segmentectomy Versus Lobectomy for Radiologically Pure Solid Clinical T1a‐bN0M0 Lung Cancer

Tsubokawa, Norifumi; Tsutani, Yasuhiro; Miyata, Yoshihiro; Handa, Yoshinori; Misumi, Keizo; Hanaki, Hideaki; Hida, Eisuke

doi:10.1007/s00268-018-4514-0

Cited by 24 publications

(16 citation statements)

References 30 publications

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“…For overall survival, 6 studies [16–20, 22] were eligible for inclusion in the analysis. The combined HR for these 6 studies was 1.52 (95% CI, 0.95–2.43; P = 0.08), and a fixed-effects model was applied (I 2 = 0%, P = 0.845), meaning that there was no significant difference between the segmentectomy and lobectomy groups (Fig.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of segmentectomy versus lobectomy for radiologically pure solid or solid-dominant stage IA non-small cell lung cancer

Rao

et al. 2019

J Cardiothorac Surg

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ObjectiveWhether segmentectomy can be used to treat radiologically determined pure solid or solid-dominant lung cancer remains controversial owing to the invasive pathologic characteristics of these tumors despite their small size. This meta-analysis compared the oncologic outcomes after lobectomy and segmentectomy regarding relapse-free survival (RFS) and overall survival (OS) in patients with radiologically determined pure solid or solid-dominant clinical stage IA non-small cell lung cancer (NSCLC).MethodsA literature search was performed in the MEDLINE, EMBASE, and Cochrane Central databases for information from the date of database inception to March 2019. Studies were selected according to predefined eligibility criteria. The hazard ratio (HR) and associated 95% confidence interval (CI) were extracted or calculated as the outcome measure for data combining.ResultsSeven eligible studies published between 2014 and 2018 enrolling 1428 patients were included in the current meta-analysis. Compared with lobectomy, segmentectomy had a significant benefit on the RFS of radiologically determined pure solid or solid-dominant clinical stage IA NSCLC patients (combined HR: 1.46; 95% CI, 1.05–2.03; P = 0.024) and there were no significant differences on the OS of these patients (HR: 1.52; 95% CI, 0.95–2.43; P = 0.08).ConclusionsSegmentectomy leads to lower survival than lobectomy for clinical stage IA NSCLC patients with radiologically determined pure solid or solid-dominant tumors. Moreover, applying lobectomy to clinical stage IA NSCLC patients with radiologically determined pure solid or solid-dominant tumors (≤2 cm) could lead to an even bigger survival advantage. However, there are some limitations in the present study, and more evidence is needed to support the conclusion.

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Section: Resultsmentioning

confidence: 99%

Meta-analysis of segmentectomy versus lobectomy for radiologically pure solid or solid-dominant stage IA non-small cell lung cancer

Rao

et al. 2019

J Cardiothorac Surg

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“…Worldwide, tumor size of 2 cm is considered the cutoff point in order to consider a sublobar resection. Several studies have shown that tumor size greater than 2 cm is an independent risk factor for recurrence in patients undergoing sublobar resections and the survival advantage or equivalence of sublobar resection is only demonstrated with tumors smaller than 2 cm (15). For these reasons, we do not indicate a segmentectomy as an intentional procedure in tumors >2 cm.…”

Section: Discussionmentioning

confidence: 73%

Video-assisted thoracic surgery segmentectomies: Brazilian experience

Camargo¹,

Söder²,

Perin³

et al. 2018

J. Vis. Surg

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There is growing enthusiasm with lung resections by video-assisted thoracic surgery (VATS) technique in Brazil. The benefits of these minimally invasive procedures and their incorporation in the routine of many Brazilian centers produced a significant increase of sublobar and lobar resections in the country. The changes in our daily practice, including improvements in lung cancer staging, the rising of lung cancer screening programs and the analysis of several recent studies showing equivalent long-term outcomes with sublobar resections, while we treat often an elderly and poor performance population, have made the thoracic surgeon to look to a sublobar resection as a potentially curative procedure. We sought to analyze the Brazilian and institutional experience with VATS sublobar anatomical resections for treatment of benign and malignant diseases, and discuss technical aspects as well. Even though is much underreported, the outcomes of VATS segmentectomies resemble what is observed around the world and constitute in an effective surgery when well indicated. The Brazilian Society of Thoracic Surgery database is improving the notification by many centers and this better quality of data will provide us a deep knowledge about the results of our procedures national-wide.

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“…A recent study revealed that the oncology effect of anatomic segmentectomy and wedge resection were equivalent, but this study was limited to patients with peripheral lung carcinoma ≤ 20 mm in size who are clinically lymph node-negative ( 5 , 12 , 25 ). According to the study by Sihoe AD, predictors of successful preoperative CT sublobar resection include the following: location in the outer third of lung parenchyma; lesions <3 cm; and no evidence of endobronchial involvement ( 9 ).…”

Section: Resultsmentioning

confidence: 99%

“…An intraoperative assessment of lymph node metastasis and an adequate surgical margin may be a viable surgical approach for pure solid tumors of clinical T1A-BN0M0 lung cancer, and patients who undergo segmental resection of tumors in the right upper lobe or basal segment have a higher rate of regional recurrence. Thus, it is necessary to perform these procedures carefully ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Wang

Zhang³

et al. 2021

Front. Surg.

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Background: In 1995, a clinical randomized controlled study (RCT) conducted by the Lung Cancer Study Group (LCSG) pointed out that the lobectomy was the gold standard for treating early lung cancer. However, with the development of technology, the results of several retrospective studies have shown that the efficacy of pulmonary segmentectomy is equivalent to that of lobectomy. Currently, it is still controversial whether segmental resection or lobectomy should be performed for early lung cancer. Thus, we aim to summarize the indications of segmentectomy.Methods: To conduct the review, previous researches involving indications of segmentectomy were collected from the literature using Pubmed. These articles were published and accepted in English in the medical literature from 2013 to 2020. We have focused on segmentectomy and its indications.Results: A total of 176 articles were retrieved from the Pubmed database, of which 31 articles included indications for segmentectomy. We summarized the relevant content, and the potential and prospect of segmentectomy for the treatment of lung cancer were emphasized.Conclusions: These findings have a number of important implications for future practice. Pulmonary segmentectomy is a very vital surgical procedure for select patients with lung cancer, which provides a novel approach for the treatment of lung cancer and the survival of lung cancer patients.

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Segmentectomy Versus Lobectomy for Radiologically Pure Solid Clinical T1a‐bN0M0 Lung Cancer

Abstract: Segmentectomy with intraoperative assessment of lymph node metastasis and adequate surgical margin may be a feasible surgical procedure for pure solid tumors in clinical T1a-bN0M0 lung cancer.

Cited by 24 publications

References 30 publications

Meta-analysis of segmentectomy versus lobectomy for radiologically pure solid or solid-dominant stage IA non-small cell lung cancer

Meta-analysis of segmentectomy versus lobectomy for radiologically pure solid or solid-dominant stage IA non-small cell lung cancer

Video-assisted thoracic surgery segmentectomies: Brazilian experience

Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

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