A Propensity-matched Study of Lobectomy Versus Segmentectomy for Radiologically Pure Solid Small-sized Non-small Cell Lung Cancer Terumoto Koike 1 , Seijiro Sato 1 , Takehisa Hashimoto 1 , Tadashi Aoki 2 , Teruaki Koike 2 , Katsuo Yoshiya 2 , Shin-ichi Toyabe 3 , Masanori Tsuchida 1 1 Division of Thoracic and Cardiovascular Surgery, Niigata University, Niigata, Japan 2 Division of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan
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A Propensity-matched Study of Lobectomy Versus Segmentectomy for Radiologically Pure Solid Small-sized Non-small Cell Lung Cancer Terumoto Koike 1, Seijiro.
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A Propensity-matched Study of Lobectomy Versus Segmentectomy for Radiologically Pure Solid Small-sized Non-small Cell Lung Cancer
1 Division of Thoracic and Cardiovascular Surgery, Niigata University, Niigata, Japan2 Division of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan3 Niigata University Crisis Management Office, Niigata University Hospital, Niigata, Japan
The authors have no conflicts of interest to declare.
BACKGROUND
1. Lobectomy has been performed as a standard surgical procedure for non-small cell lung cancer (NSCLC) patients.
2. In NSCLC patients with a large proportion of ground-glass opacity (GGO) component on CT, excellent surgical outcomes after limited resection were demonstrated.
3. Indications for limited resection for NSCLC patients with radiologically pure solid tumors remain controversial.
OBJECTIVE
To compare postoperative outcomes after lobectomy and segmentectomy in patients with small radiologically pure solid NSCLC.
METHODS (1)
Patients
Inclusion Criteria:1. cT1a N0 M0 NSCLC (≤2 cm)2. Radiologically “pure solid” appearance3. Peripheral location4. Underwent lobectomy or segmentectomy in 1998—
20095. Complete resection
1. Preoperative characteristics werematched using propensity score methods.2. Overall survival (OS) and disease-free survival (DFS) were evaluatedby the log-rank test and McNemar test.3. The preoperative factors and surgical procedure were
analyzed with a multivariate analysis for OS and DFS.
METHODS (2)
AnalysisRadiologically Pure Solid cT1a
N0 M0 NSCLC Patients (n = 251)
Lobectomy(n = 151)
Segmentectomy(n = 100)
Lobectomy(n = 87)
Segmentectomy(n = 87)
Propensity Score—Matching
RESULTS
Post-adjustment Preoperative Characteristics of the Patients with Radiologically Pure Solid cT1a N0 M0 NSCLC
Characteristic Lobectomy Segmentectomy P value
All cases, n 87 87
Age [y], median (range) 68 (37–81) 68 (42–83) .399
Sex, n (%) Male 48 (55) 51 (59) .760
Female 39 (45) 36 (41)
Smoking index, median (range) 500 (0–2200) 500 (0–2400) .809