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Comparative Study
. 2022 Jan 16;22(1):71.
doi: 10.1186/s12885-021-09129-0.

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

Yaodong Zhou #  1 , Tao Yu #  2 , Yixin Zhang  3 , Liqiang Qian  4 , Qing Xia  5
Affiliations
Comparative Study

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

Yaodong Zhou et al. BMC Cancer. .

Abstract

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.

Keywords: Ground-glass opacity; NSCLC; Propensity score matching; Segmentectomy; Wedge resection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of study enrolment and exclusion
Fig. 2
Fig. 2
The 5-year RFS and OS in simple segmentectomy group was 94 and 95%, and in wedge resection group was 95 and 96%. There was no difference on the RFS and OS between simple segmentectomy group and wedge resection group
Fig. 3
Fig. 3
The pulmonary function changes in simple segmentectomy group and wedge resection group. A-D There were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), predicted diffusing capacity of the lung of carbon monoxide percentage (%DLCO) and peak expiratory flow (PEF) preoperatively at 3, 6 and 12 months postoperatively in patients undergoing simple segmentectomy group and wedge resection group
See this image and copyright information in PMC

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