For a study, researchers sought to understand that although wedge resection and complex segmentectomy are rarely compared in the literature, sublobar resection is a common treatment for lung cancer. They used a large cohort, multicenter database, and propensity score-matched analysis to examine the oncological results of complex segmentectomy and wedge resection for clinical stage 0-IA lung cancer. A retrospective data research involved 506 patients with lung cancer who underwent surgical resection at 3 institutions between 2010 and 2018 and had clinical stage 0-IA, solid component size less than or around 2.0 cm. On all patients and their propensity score-matched couples, the outcomes of complex segmentectomy (n=222) and “location-adjusted” wedge resection (n=284) were assessed. The 5-year recurrence-free interval [RFI] rates were 96.9% vs. 86.1%, while the 5-year cancer-specific survival rate was 97.4% vs. 93.7%. In every group, patients who received difficult segmentectomy often had a better prognosis than those who had wedge resection. Similar patterns were observed in sub-analyses that only looked at solid tumors. In 179 propensity score-matched pairs, patients who underwent complex segmentectomy frequently had a better prognosis than those who underwent wedge resection (5-year cancer-specific survival rates, 96.8% vs. 92.9%; 5-year RFI rates, 96.3% vs. 87.5%). A multivariate Cox regression analysis for RFI revealed that complex segmentectomy significantly reduced lung cancer recurrence in comparison to wedge resection (hazard ratio, 0.32; 95% CI, 0.12-0.73; P=.0061). Wedge resection may not offer the best oncological outcomes when compared to complex segmentectomy.

 

Source: sciencedirect.com/science/article/abs/pii/S1525730421002679