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Comparative Study
. 2013 Aug;146(2):358-64.
doi: 10.1016/j.jtcvs.2013.02.008. Epub 2013 Mar 8.

Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage IA lung adenocarcinoma: propensity score-matched analysis in a multicenter study

Yasuhiro Tsutani  1 , Yoshihiro Miyata, Haruhiko Nakayama, Sakae Okumura, Shuji Adachi, Masahiro Yoshimura, Morihito Okada
Affiliations
Free article
Comparative Study

Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage IA lung adenocarcinoma: propensity score-matched analysis in a multicenter study

Yasuhiro Tsutani et al. J Thorac Cardiovasc Surg. 2013 Aug.
Free article

Abstract

Objective: Our objective was to compare the oncologic outcomes of lobectomy and segmentectomy for clinical stage IA lung adenocarcinoma.

Methods: We examined 481 of 618 consecutive patients with clinical stage IA lung adenocarcinoma who underwent lobectomy or segmentectomy after preoperative high-resolution computed tomography and F-18-fluorodeoxyglucose positron emission tomography/computed tomography. Patients (n = 137) who underwent wedge resection were excluded. Lobectomy (n = 383) and segmentectomy (n = 98) as well as surgical results were analyzed for all patients and their propensity score-matched pairs.

Results: Recurrence-free survival (RFS) and overall survival (OS) were not significantly different between patients undergoing lobectomy (3-year RFS, 87.3%; 3-year OS, 94.1%) and segmentectomy (3-year RFS, 91.4%; hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.27-1.20; P = .14; 3-year OS, 96.9%; HR, 0.49; 95% CI, 0.17-1.38; P = .18). Significant differences in clinical factors such as solid tumor size (P < .001), maximum standardized uptake value (SUVmax) (P < .001), and tumor location (side, P = .005; lobe, P = .001) were observed between both treatment groups. In 81 propensity score-matched pairs including variables such as age, gender, solid tumor size, SUVmax, side, and lobe, RFS and OS were similar between patients undergoing lobectomy (3-year RFS, 92.9%, 3-year OS, 93.2%) and segmentectomy (3-year RFS, 90.9%; 3-year OS, 95.7%).

Conclusions: Segmentectomy is suitable for clinical stage IA lung adenocarcinoma, with survivals equivalent to those of standard lobectomy.

Keywords: 10; CI; FDG-PET/CT; GGO; HRCT; NSCLC; OS; RFS; SUVmax; [18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography; confidence interval; ground-glass opacity; high-resolution computed tomography; maximum standardized uptake value; non–small cell lung cancer; overall survival; recurrence-free survival.

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Comment in

  • Is segmentectomy suitable for solid-type lung cancer?
    Sawabata N. Sawabata N. J Thorac Cardiovasc Surg. 2013 Sep;146(3):728-9. doi: 10.1016/j.jtcvs.2013.04.019. J Thorac Cardiovasc Surg. 2013. PMID: 23953304 No abstract available.
  • Reply to the editor.
    Tsutani Y, Miyata Y, Okada M. Tsutani Y, et al. J Thorac Cardiovasc Surg. 2013 Sep;146(3):729. doi: 10.1016/j.jtcvs.2013.04.020. J Thorac Cardiovasc Surg. 2013. PMID: 23953305 No abstract available.

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