Segmentectomy versus lobectomy in the United States: Outcomes after resection for first primary lung cancer and treatment patterns for second primary lung cancers

Potter, Alexandra L.; Kim, Joshua; McCarthy, Meghan; Senthil, Priyanka; Mathey-Andrews, Camille; Kumar, Arvind; Cao, Christopher; Lin, Mong-Wei; Lanuti, Michael; Martin, Linda W.; Yang, Chi‐Fu Jeffrey

doi:10.1016/j.jtcvs.2023.07.009

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Furthermore, subgroup analyses by histology and tumor grade exhibited no difference. Similar treatment patterns were also observed between the two approaches for second primary tumors [36]. A recent meta-analysis of randomized clinical trials comparing sublobar to lobar resection in stage IA NSCLC showed sublobar resection and lobectomy to have similar OS, DFS, and disease recurrence rates for stage IA NSCLC [37].…”

Section: Is Sublobar Resection Superior To Lobectomy For Stage Ia Nsc...mentioning

confidence: 60%

Recent Advancements in Minimally Invasive Surgery for Early-Stage Non-Small Cell Lung Cancer: A Narrative Review

Ibrar,

Albalkhi,

Garatli

et al. 2024

Preprint

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Introduction: Lung cancer remains a global health concern, with non-small cell lung cancer (NSCLC) comprising the majority of cases. Early detection of lung cancer has led to an increased number of cases identified in the earlier stages of NSCLC. This required the revaluation of the NSCLC treatment approaches for early-stage NSCLC. Methods: We conducted a comprehensive search using multiple databases to identify relevant studies on treatment modalities for early-stage NSCLC. Inclusion criteria prioritized but were not limited to, clinical trials and meta-analyses on surgical approaches to early-stage NSCLC conducted from 2021 onwards. Discussion: Minimally invasive approaches, such as VATS and RATS, along with lung resection techniques, including sublobar resection have emerged as treatments for early-stage NSCLC. Ground-glass opacities (GGOs) hve shown prognostic significance, especially when analyzing the consolidation-tumor ratio (CTR). There have also been updates on managing GGOs, including the non-surgical approaches, the extent of lung resection indicated, and the level of lymphadenectomy required. Conclusion: The management of early-stage NSCLC requires further assessment of treatment strategies. This includes understanding the required extent of surgical resection, interpreting the significance of GGOs (specifically GGOs with a high CTR), and evaluating the efficacy of alternative therapies. Customized treatment involving surgical and non-surgical interventions is essential for advancing patient care.

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Section: Is Sublobar Resection Superior To Lobectomy For Stage Ia Nsc...mentioning

confidence: 60%

Recent Advancements in Minimally Invasive Surgery for Early-Stage Non-Small Cell Lung Cancer: A Narrative Review

Ibrar,

Albalkhi,

Garatli

et al. 2024

Preprint

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“…For a long time, lobectomy is the standard surgical procedure for stage I NSCLC ( 25 ). In recent years, some evidence has shown that segmentectomy has better outcomes than lobectomy in stage IA1-2 (T1a-bN0M0) NSCLC ( 4 – 6 ). However, whether this conclusion is valid in stage IA3 (T1cN0M0) NSCLC remains controversial in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…However, in recent years, with the introduction of minimally invasive concepts, how to protect lung function as much as possible under the same survival efficacy has received attention from thoracic surgeons around the world ( 3 ). For stage IA1-2 (T1a-bN0M0) NSCLC, segmentectomy has been proven to have better perioperative efficacy, lung function protection, and noninferior survival efficacy compared with lobectomy ( 4 – 6 ). However, whether this conclusion is valid in stage IA3 NSCLC remains controversial in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Lobectomy versus segmentectomy for stage IA3 (T1cN0M0) non-small cell lung cancer: a meta-analysis and systematic review

Zhang,

Chen,

Lin

et al. 2023

Front. Oncol.

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BackgroundSegmentectomy has been proven to have better survival and perioperative efficacy than lobectomy for non-small cell lung cancer (NSCLC) up to 2 cm. Whether this result is applicable to stage T1cN0M0 NSCLC (2.1 to 3 cm) remains controversial.MethodsWe conducted a comprehensive search across seven databases to identify relevant studies comparing lobectomy and segmentectomy procedures. Our primary focus was on survival indicators (overall survival [OS] and disease-free survival [DFS]), while for secondary outcomes, operative outcomes, hospitalization outcomes, recurrences, and complications were considered.ResultsAfter screening, the final analysis included 10 studies (involving 22113 patients in the lobectomy group and 1627 patients in the segmentectomy group). The lobectomy procedure achieved better OS (hazard ratio [HR]: 1.19 [1.07~1.33]) and DFS (HR: 1.37 [1.10~1.71]), which were proven in all subgroups. The OS rate at 2-5 years and DFS rate at 4-5 years were higher in the lobectomy group. The advantages of OS and DFS in the lobectomy group increased over the survival time. More lymph node dissections, intraoperative blood loss and total complications were found in the lobectomy group. Similar hospital stays, 90-day mortality and conversion thoracotomy were found between the two groups.ConclusionLobectomy appeared to be the better choice for patients with stage T1cN0M0 NSCLC with better survival (OS and DFS). However, the complications needed to be taken seriously.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identification CRD42023445013.

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“…[2] Some studies, such as JCOG 0802 and CALGB 140503, have shown that for patients with early-stage pulmonary nodules, the oncologic outcomes of anatomical segmentectomy are not inferior to those of traditional lobectomy. [3][4][5] Consequently, the application of anatomical segmentectomy instead of lobectomy to treat early-stage lung cancer in selected patients has been widely discussed. However, segmentectomy is technically more sophisticated than lobectomy because of the anatomical complexity and variations of peripheral vessels and bronchi, especially in the right lateral basal segment (RS9).…”

Section: Introductionmentioning

confidence: 99%

“…7%), all of which were improved after conservative treatment. The median postoperative drainage time was 5(3)(4)(5)(6)(7)(8)(9)(10)(11) days, and the median length of postoperative hospital stay was 5(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) days. Final pathologies of lesions included minimally invasive adenocarcinoma (MIA) in 21 cases (77.8%) and adenocarcinoma in situ (AIS) in 6 cases (22.2%)(Table…”

mentioning

confidence: 99%

Application of Three-dimensional Reconstruction in Anatomical Right Lateral Basal (RS9) Segmentectomy

Zhu,

Yang,

Lin

et al. 2024

Preprint

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Objective This study analyzed the application of three-dimensional (3D) reconstruction in the vascular and bronchial branching patterns of right anterior, lateral, and posterior basal segments (RS8, RS9, and RS10) and anatomical RS9 segmentectomy. Methods From May 2020 to May 2022, 354 patients were selected for 3D reconstruction of vascular and bronchial branching patterns using Mimics 21.0. Based on the preoperative and intraoperative 3D reconstruction data, anatomical RS9 segmentectomy was conducted among 27 patients, and the surgical outcomes were retrospectively analyzed. Results The branching patterns of the right basal bronchi (B8, B9, and B10) were divided into the B8 and B9 + 10 type (74.6%), the B8 + 9 and B10 type (15.3%) and the B8 and B9 and B10 type (10.2%). The branching patterns of the right basal arteries (A8, A9 and A10) were classified into simple bifurcated type (the A8 and A9 + 10 type (62.4%) and the A8 + 9 and A10 type (13.0%)), split bifurcated type (the A8 and A8 + 9 + 10 type (18.4%) and the A8 + 9 and A9 + 10 type (3.7%)) and trifurcated type (the A8, A9 and A10 type (2.5%)). The branching patterns of the right basal veins (V8, V9, and V10) were complex and were classified into simple bifurcated, split bifurcated, and trifurcated types and further divided into ten subtypes. Of these types, the V8 + 9 and V10 type, the V8 + 9 + 10 and V10 type, and the V8 + 9 and V9 + 10 type were most common, accounting for 29.4%, 25.4% and 21.5% of cases, respectively. Anatomical RS9 segmentectomy was successfully completed without conversion to thoracotomy in all 27 patients. Conclusions 3D reconstruction is a practical tool for analyzing the bronchovascular branching patterns of RS8, RS9, and RS10. The application of 3D reconstruction is safe and feasible in anatomical RS9 segmentectomy.

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Segmentectomy versus lobectomy in the United States: Outcomes after resection for first primary lung cancer and treatment patterns for second primary lung cancers

Cited by 6 publications

References 25 publications

Recent Advancements in Minimally Invasive Surgery for Early-Stage Non-Small Cell Lung Cancer: A Narrative Review

Recent Advancements in Minimally Invasive Surgery for Early-Stage Non-Small Cell Lung Cancer: A Narrative Review

Lobectomy versus segmentectomy for stage IA3 (T1cN0M0) non-small cell lung cancer: a meta-analysis and systematic review

Application of Three-dimensional Reconstruction in Anatomical Right Lateral Basal (RS9) Segmentectomy

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