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Segmentectomy versus lobectomy in early non‐small cell lung cancer of 2 cm or less in size: A population‐based study
Author(s) -
Moon Mi Hyoung,
Moon Young Kyu,
Moon Seok Whan
Publication year - 2018
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13277
Subject(s) - medicine , lung cancer , propensity score matching , hazard ratio , stage (stratigraphy) , mediastinal lymph node , lymph node , dissection (medical) , surgery , pneumonectomy , confidence interval , cancer , metastasis , paleontology , biology
Background and objective Standard surgical management for early stage lung cancer is lobectomy with mediastinal lymph node dissection. The feasibility of limited resection remains controversial; we retrospectively assessed lung cancer‐specific survival (LCSS) and overall survival (OS) in early stage non‐small cell lung cancer (NSCLC) to evaluate whether segmentectomy is comparable to standard lobectomy. Methods Patients with primary NSCLC of 20 mm or less who were diagnosed from 2000 to 2014 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. To compare the two surgical interventions, a propensity score analysis was performed between lobectomy and segmentectomy. Results Of the 15 358 patients analysed, there were 14 549 lobectomies and 809 segmentectomies. The 5‐year OS was 76% for the lobectomy group and 74.4% for the segmentectomy group. There were no significant differences in OS or LCSS among patients who underwent lobectomy versus segmentectomy, as demonstrated by the propensity‐matched hazard ratio (HR) for OS (HR: 1.195, 95% CI: 0.993–1.439) and LCSS (HR: 1.124, 95% CI: 0.860–1.469). The inverse propensity‐weighted analysis also supported these results. Segmentectomy was more likely to be performed in elderly patients. In the subset of patients aged ≥75 years, the segmentectomy group demonstrated comparable OS (HR: 1.17, 95% CI: 0.87–1.58, P = 0.31) and LCSS (HR: 0.94, 95% CI: 0.59–1.51, P = 0.81), compared with the lobectomy group. Conclusion Equivalent OS and LCSS were demonstrated in patients with primary NSCLC of 20 mm or less without lymph node or distant metastasis.