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Sublobar resections in stage IA non-small cell lung cancer: segmentectomy versus wedge resection

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

The aims of this study were to compare recurrence rate and recurrence-free survival following wedge resection and segmentectomy in stage IA non-small cell lung cancer (NSCLC) and to validate the impact of the type of limited resection, according to tumor size, and surgical margin.

Methods

Anatomical segmentectomy was performed in 89 and wedge resection in 149 clinical stage IA NSCLC patients. Forty-four (29.5 %) patients in the wedge resection group and 12 (13.5 %) patients in the segmentectomy group were selected for sublobar resection because of high-risk status. The outcomes included type of recurrence and survival time. The surgical margin was measured retrospectively, and the margin/tumor size ratio (M/S ratio) was calculated.

Results

Forty-two of 149 (28.2 %) wedge resection patients and 13 of 89 (14.6 %) segmentectomy patients experienced recurrence during the follow-up period. The locoregional recurrence rate in the wedge resection group was significantly higher than in the segmentectomy group (p = 0.028). A multivariate analysis showed that wedge resection (p = 0.0437), a high percentage of solid tumor (p = 0.0399), and a low M/S ratio (p = 0.0003) were significant independent factors associated with decreased recurrence-free survival. For tumors 1.4 cm in size or greater, segmentectomy was associated with a longer recurrence-free survival. Recurrence-free survival after segmentectomy among patients with an M/S ratio greater than 1 was favorable.

Conclusions

The M/S ratio should be obtained when limited resection is considered for stage IA NSCLC. Segmentectomy with lymphadenectomy should be preferred for patients with tumor size greater than 1.4 cm.

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Conflict of interest

The authors declare that they have no competing interests.

Authors’ contributions

MaT, MuT, SY and DS analyzed and interpreted the patient data. MaT performed the literature review and was a major contributor in writing the manuscript. IM performed the final editing of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of General and Cardiothoracic Surgery, School of Medicine, Kanazawa University, Takara-machi 13-1, Kanazawa, 920-8640, Japan

    Masaya Tamura, Isao Matsumoto, Munehisa Takata, Shuhei Yoshida & Daisuke Saito

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  1. Masaya Tamura
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  2. Isao Matsumoto
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  3. Munehisa Takata
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  4. Shuhei Yoshida
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  5. Daisuke Saito
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Correspondence to Masaya Tamura.

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Tamura, M., Matsumoto, I., Takata, M. et al. Sublobar resections in stage IA non-small cell lung cancer: segmentectomy versus wedge resection. Indian J Thorac Cardiovasc Surg 30, 264–271 (2014). https://doi.org/10.1007/s12055-014-0317-6

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  • DOI: https://doi.org/10.1007/s12055-014-0317-6

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