Solid-dominant lung cancer histology no barrier to segmentectomy

Complete resection with segmentectomy is as effective as lobectomy for patients with solid-dominant clinical stage IA lung adenocarcinoma, Japanese study findings suggest.

Recurrence-free survival (RFS) did not significantly differ between the 286 patients who underwent lobectomy and the 41 patients who had segmentectomy, with 3-year rates of 84.4% and 84.8%, respectively.

Nor did the pattern of local (5.6 vs 7.3%) or distant (9.1 vs 4.9%) recurrence significantly differ between the lobectomy and segmentectomy surgical groups, report Morihito Okada, from Hiroshima University, and colleagues.

Three-year rates of RFS were also comparable after lobectomy and segmentectomy for 182 patients with mixed ground-glass opacity tumours (91.0 and 85.0%, respectively) and 145 patients with pure solid tumours (76.8 and 84.7%, respectively).

Indeed, in multivariate analysis, RFS was predicted only by solid tumour size on preoperative high-resolution computed tomography (hazard ratio [HR]=1.67) and the maximum standardised uptake value during preoperative F-18-fluorodeoxyglucose positron emission tomography/computed tomography (HR=1.18).

By contrast, gender, tumour type and surgical procedure had no significant impact on patient outcome, say Okada et al in the European Journal of Cardio-thoracic Surgery.

“Segmentectomy for solid-dominant clinical stage IA lung adenocarcinoma showed RFS equivalent to that of standard lobectomy in our selected patients”, the researchers conclude.

“Segmentectomy can be performed even for a pure solid tumour under strict intraoperative lymph node examination.”

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