scholarly journals 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

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yaodong Zhou ◽  
Tao Yu ◽  
Yixin Zhang ◽  
Liqiang Qian ◽  
Qing Xia
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Pulmonary Function ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Wedge Resection ◽  
Small Cell ◽  
Comparable Efficacy ◽  
Small Cell Lung ◽  
Resection Group

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.

Wedge resection versus segmentectomy in patients with stage I non–small-cell lung cancer unfit for lobectomy

2019 ◽  
Vol 49 (12) ◽  
pp. 1134-1142 ◽  
Author(s):  
Yasuhiro Tsutani ◽  
Atsushi Kagimoto ◽  
Yoshinori Handa ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Operative Procedure ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung

Abstract Objective The present study aimed to compare the outcomes of wedge resection and segmentectomy in patients with clinical stage I non–small-cell lung cancer (NSCLC) who were unfit for lobectomy. Methods Between April 2007 and December 2015, 99 patients with stage I NSCLC who were considered unfit for lobectomy and had undergone sublobar resection were identified. Propensity scores were estimated for multivariable analyses, and surgical outcomes were compared between patients who underwent wedge resection and those who underwent segmentectomy. Results Sixty patients underwent wedge resection and 39 underwent segmentectomy. Severe postoperative complications (>Grade IIIa) were more frequent in segmentectomy (15.4%) than in wedge resection (3.3%, P = 0.054). Propensity score-adjusted multivariable analysis revealed that operative procedure was an independent predictive factor for severe postoperative complication (segmentectomy, odds ratio = 8.18; P = 0.021). Overall survival (OS) and recurrence-free survival (RFS) were not significantly different between wedge resection (5-year OS, 61.3%, 5-year RFS, 49.4%) and segmentectomy (5-year OS, 68.2%, 5-year RFS, 56.8 %, P = 0.95, P = 0.93, respectively). Propensity score-adjusted multivariable Cox analysis revealed that operative procedure was not an independent factor for OS (segmentectomy, hazard ratio = 1.21, P = 0.62) or RFS (segmentectomy, hazard ratio = 1.07, P = 0.84). Conclusion Segmentectomy was more toxic but failed to show the superiority of survival compared with wedge resection. Wedge resection may be the optimal procedure for patients with clinical stage I NSCLC who are considered to be unfit for lobectomy.

scholarly journals A national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non–small cell lung cancer

2017 ◽  
Vol 154 (2) ◽  
pp. 675-686.e4 ◽  
Author(s):  
Babatunde A. Yerokun ◽  
Chi-Fu Jeffrey Yang ◽  
Brian C. Gulack ◽  
Xuechan Li ◽  
Michael S. Mulvihill ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stereotactic Body Radiation Therapy ◽  
Wedge Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Ia ◽  
National Analysis

Effect of 125 I Interstitial Brachytherapy on Pulmonary Function in Patients with Early Non-Small Cell Lung Cancer

Brachytherapy ◽  
2017 ◽  
Vol 16 (3) ◽  
pp. S93-S94
Author(s):  
Xiaodong Huo ◽  
Bin Huo ◽  
Haitao Wang ◽  
Shude Chai ◽  
Lei Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Function ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Interstitial Brachytherapy ◽  
Small Cell Lung

Impact of Preoperative Chemotherapy on Pulmonary Function Tests in Resectable Early-Stage Non-small Cell Lung Cancer

CHEST Journal ◽  
2009 ◽  
Vol 135 (6) ◽  
pp. 1588-1595 ◽  
Author(s):  
M. Patricia Rivera ◽  
Frank C. Detterbeck ◽  
Mark A. Socinski ◽  
Dominic T. Moore ◽  
Martin J. Edelman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Function ◽  
Small Cell Lung Cancer ◽  
Preoperative Chemotherapy ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Pulmonary Function Tests ◽  
Small Cell ◽  
Small Cell Lung ◽  
Function Tests

scholarly journals Lobectomy Versus Segmentectomy in Patients with Stage T (>2 cm and ≤3 cm) N0M0 Non-small Cell Lung Cancer: A Propensity Score Matching Study

2020 ◽  
Author(s):  
Linlin Wang ◽  
Lihui Ge ◽  
Guofeng Zhang ◽  
Yi Ren ◽  
Yongyu Liu
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Small Cell ◽  
Seer Database ◽  
Regression Analyses ◽  
Small Cell Lung

Abstract Background: Whether lung segmentectomy is a safe and effective surgical treatment in patients with early non-small cell lung cancer (NSCLC) remains controversial. We have therefore reviewed the clinicopathologic characteristics and survival outcomes of patients receiving a lobectomy vs. segmentectomy to treat early T (>2 cm and ≤3 cm) N0M0 NSCLC.Methods: We obtained data from the Surveillance, Epidemiology, and End Results (SEER) database for patients who underwent lobectomy or segmentectomy between 2004 and 2015. To reduce bias and imbalance between the treatment groups, propensity score matching (PSM) analysis was performed. We used Kaplan-Meier curves to estimate overall survival (OS) and lung cancer-specific survival (LCSS), performed univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for OS and CSS, and applied the Cox proportional hazards model to create forest plots. Results: A total of 5783 patients from the SEER database were included. Of these, 5531 patients underwent lobectomy, and 252 patients underwent segmentectomy. Before matching, both univariate and multivariate Cox regression analyses showed that patients who underwent lobectomy had better OS (hazard ratio [HR]: 1.561; 95% confidence interval [CI] 1.292-1.885; P <0.001) and LCSS (HR: 1.551; 95% CI 1.198-2.009; P=0.001) than patients who underwent segmentectomy. However, survival differences between the groups were not significant; OS (P=0.160) and LCSS (P=0.097) after matching. Regression analyses revealed that age, sex, lymph node dissection, and grade were independent predictors of OS and LCSS (P <0.05).Conclusions: For patients with stage T (>2 cm and ≤3 cm) N0M0 non-small cell lung cancer, segmentectomy can achieve the same OS and LCSS compared with lobectomy. A large number of patients require further long-term follow-up analyses.

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