Author of

• 20169

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  P2.05 - Early Stage NSCLC (ID 706)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23354

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    P2.05-011 - Segmentectomy versus Wedge Resection in Patients with Clinical Stage I Non-Small Cell Lung Cancer Who Were Unfit for Lobectomy (ID 8208)

    09:30 - 09:30  |  Author(s): R. Hirohata
    • Abstract
    • Slides

    Background:
    The purpose of this study is to compare the surgical outcomes after segmentectomy versus wedge resection in patients with clinical stage I non-small cell lung cancer (NSCLC) who were unfit for lobectomy.
    
    Method:
    Between April 2007 and December 2015, 99 patients with clinical stage I NSCLC who were considered unfit for lobectomy and underwent sublobar resection were identified. Propensity scores were estimated including variables such as age, sex, smoking history, solid tumor size, SUVmax of the tumor, preoperative pulmonary functions, and Charlson comorbidity index. Surgical outcomes were compared between patients who underwent segmentectomy and those who underwent wedge resection.
    
    Result:
    Thirty-nine patients underwent segmentectomy and sixty patients underwent wedge resection. Operation time (median, 169 min vs. 72.5 min, P <0.001) and blood loss (median, 84 g vs. 10 g, P = 0.001) were significantly different between the procedures. Severe postoperative complications (> Grade IIIa) was more frequently in segmentectomy (15.4%) than in wedge resection (3.3%, P = 0.054). Propensity score-adjusted multivariable analysis showed 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 segmentectomy (3 y-OS, 79.1%, 3 y-RFS, 77.7%) and wedge resection (3 y-OS, 86.3%, 3 y-RFS, 68.5%; P = 0.81, P = 0.91, respectively). Propensity score-adjusted multivariable Cox analysis revealed that operative procedure was not an independent factor for OS (segmentectomy, hazard ratio = 1.7, P = 0.24) or RFS (segmentectomy, hazard ratio = 1.1, P = 0.82). In propensity score matching method, similar results were observed.
    
    Conclusion:
    Segmentectomy is more toxic, but provides similar prognosis compared with wedge resection. Wedge resection may be an optimal procedure in patients with clinical stage I NSCLC who were considered unfit for lobectomy.
    
    

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