Segmentectomy has a Worse Prognosis than Lobectomy for clinical T1c Pure-solid Non-small Cell Lung Cancer
Presented During:
Saturday, May 6, 2023: 8:00AM - Tuesday, May 9, 2023: 11:45AM
Los Angeles Convention Center
Posted Room Name:
Outside of Room 408
Abstract No:
PS065
Submission Type:
Abstract Submission
Authors:
Kenta Nakahashi (1), Chikara Nakagami (1), Marina Nakatsuka (1), Makoto Endoh (1), Satoshi Shiono (2)
Institutions:
(1) Yamagata Prefectural Central Hospital, Yamagata, Japan, (2) Yamagata University, Yamagata, Japan
Submitting Author:
Kenta Nakahashi
-
Contact Me
Yamagata Prefectural Central Hospital
Yamagata Prefectural Central Hospital
Co-Author(s):
Chikara Nakagami
-
Contact Me
Yamagata Prefectural Central Hospital
Yamagata Prefectural Central Hospital
Marina Nakatsuka
-
Contact Me
Yamagata Prefectural Central Hospital
Yamagata Prefectural Central Hospital
Makoto Endoh
-
Contact Me
Yamagata Prefectural Central Hospital
Yamagata Prefectural Central Hospital
Satoshi Shiono
-
Contact Me
Yamagata University
Yamagata University
Presenting Author:
Kenta Nakahashi
-
Contact Me
N/A
N/A
Abstract:
Objective: The benefits of segmentectomy for non-small cell lung cancer (NSCLC) >2 cm were demonstrated in the JCOG0802 and CALGB140503 trial results. However, for clinical T1c NSCLC, its benefits remain unclear. This study aimed to investigate the outcome of segmentectomy for clinical T1c NSCLC.
Methods: A total of 257 patients who underwent anatomical resection and lymph node dissection for clinical T1c NSCLC from January 2006 to April 2020 were enrolled. All patients were divided into two groups: segmentectomy and lobectomy, and a retrospective analysis was conducted. Kaplan–Meier method was used to estimate relapse-free survival (RFS) curves, and significance was assessed using log-rank test.
Results: The median age of all patients was 70 years (164 males and 93 females); 224 patients underwent lobectomy, and 33 patients underwent segmentectomy. Only the pathological T factor was significantly more advanced in the segmentectomy group than in the lobectomy group. There were no significant differences in age (median 74 years vs. 70 years), sex (24 males and 9 females vs. 140 males and 84 females), pulmonary function, carcinoembryonic antigen (CEA) (median 3.2 ng/mL vs. 3.2 ng/mL), maximum standardized uptake value (SUVmax) (median 4.7 vs. 7.8), and clinical stage between the segmentectomy and lobectomy groups. The median observation period was 47 months. In the RFS curve analysis, the 5-year RFS rate was significantly higher in the lobectomy group (69.8%) than the segmentectomy group (59.6%) (p = 0.24). Conversely, as the figure shows, in the RFS curve analysis of pure-solid NSCLC, the 5-year RFS rate was significantly higher in the lobectomy group (68.8%) than the segmentectomy group (46.2%) (p < 0.01). Among the pure-solid NSCLC, univariable analysis identified age (hazard ratio [HR] = 1.03, p = 0.02), %FVC (<80%; HR = 2.99, p = 0.01), CEA (>5.0 ng/mL; HR = 2.45, p < 0.01), SUVmax (>5.0; HR = 2.38, p < 0.01), and segmentectomy (HR = 2.04, p = 0.03) as significant prognostic factors for RFS. Multivariable analysis identified CEA (>5.0 ng/mL; HR = 2.14, p < 0.01), SUVmax (>5.0; HR = 1.95, p = 0.04), and segmentectomy (HR = 2.14, p = 0.02) as significant independent prognostic factors for RFS.
Conclusions: There is no significant difference in survival outcome between the segmentectomy and lobectomy groups in clinical T1c NSCLC; however, in clinical T1c pure-solid NSCLC, the segmentectomy group has a worse prognosis than the lobectomy group.
Methods: A total of 257 patients who underwent anatomical resection and lymph node dissection for clinical T1c NSCLC from January 2006 to April 2020 were enrolled. All patients were divided into two groups: segmentectomy and lobectomy, and a retrospective analysis was conducted. Kaplan–Meier method was used to estimate relapse-free survival (RFS) curves, and significance was assessed using log-rank test.
Results: The median age of all patients was 70 years (164 males and 93 females); 224 patients underwent lobectomy, and 33 patients underwent segmentectomy. Only the pathological T factor was significantly more advanced in the segmentectomy group than in the lobectomy group. There were no significant differences in age (median 74 years vs. 70 years), sex (24 males and 9 females vs. 140 males and 84 females), pulmonary function, carcinoembryonic antigen (CEA) (median 3.2 ng/mL vs. 3.2 ng/mL), maximum standardized uptake value (SUVmax) (median 4.7 vs. 7.8), and clinical stage between the segmentectomy and lobectomy groups. The median observation period was 47 months. In the RFS curve analysis, the 5-year RFS rate was significantly higher in the lobectomy group (69.8%) than the segmentectomy group (59.6%) (p = 0.24). Conversely, as the figure shows, in the RFS curve analysis of pure-solid NSCLC, the 5-year RFS rate was significantly higher in the lobectomy group (68.8%) than the segmentectomy group (46.2%) (p < 0.01). Among the pure-solid NSCLC, univariable analysis identified age (hazard ratio [HR] = 1.03, p = 0.02), %FVC (<80%; HR = 2.99, p = 0.01), CEA (>5.0 ng/mL; HR = 2.45, p < 0.01), SUVmax (>5.0; HR = 2.38, p < 0.01), and segmentectomy (HR = 2.04, p = 0.03) as significant prognostic factors for RFS. Multivariable analysis identified CEA (>5.0 ng/mL; HR = 2.14, p < 0.01), SUVmax (>5.0; HR = 1.95, p = 0.04), and segmentectomy (HR = 2.14, p = 0.02) as significant independent prognostic factors for RFS.
Conclusions: There is no significant difference in survival outcome between the segmentectomy and lobectomy groups in clinical T1c NSCLC; however, in clinical T1c pure-solid NSCLC, the segmentectomy group has a worse prognosis than the lobectomy group.
Categories:
Lung Cancer
Image or Table
