Lobectomy versus segmentectomy: a propensity score-matched comparison of postoperative complications,pulmonary function and prognosis |
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| Authors: | Hiroaki Nomori Ikuo Yamazaki Youichi Machida Ayumu Otsuki Yue Cong Hiroshi Sugimura Yu Oyama |
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| Institution: | 1. Department of Thoracic Surgery, Kashiwa Kousei General Hospital, Chiba, Japan;2. Department of Radiology, Kameda Medical Center, Kamogawa, Japan;3. Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan;4. Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan;5. Department of Thoracic Surgery, Kameda Medical Center, Kamogawa, Japan;6. Department of Medical Oncology, Kameda Medical Center, Kamogawa, Japan |
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| Abstract: | Open in a separate windowOBJECTIVESTo demonstrate the differences in clinical outcomes between lobectomy and segmentectomy for non-small cell lung cancer using propensity score matching.METHODSA single-centre, retrospective, matched cohort study was conducted in clinical T1N0M0 non-small cell lung cancer patients treated by surgery between 2012 and 2019. Differences in freedom from recurrence, overall survival, postoperative complications, chest drainage and preservation of pulmonary function between lobectomy and segmentectomy were evaluated using the propensity score model. Matched variables of patients were age, sex, comorbidity index and pulmonary function. Matched variables of tumours were tumour size, T-stage, fluorodeoxyglucose uptake on positron emission tomography, histopathology, lobe site and tumour distance ratio from the hilum.RESULTSOf the 112 patients treated by lobectomy and 233 patients treated by segmentectomy, 93 patients each from both groups were selected after the matching. The median tumour distance ratio from hilum was 0.7 in lobectomy and 0.8 in segmentectomy group (P = 0.59), i.e. almost outer third tumour location. There were no significant differences in freedom from recurrence (P = 0.38), overall survival (P = 0.51), postoperative complications (P = 0.94), drainage period (P = 0.53) and prolonged air leakage (P = 0.82) between the two. Median preservation of pulmonary function was 93.2% after segmentectomy, which was significantly higher than 85.9% after lobectomy (P < 0.001).CONCLUSIONSFreedom from recurrence, overall survival, postoperative complications and chest drainage were similar between segmentectomy and lobectomy. Segmentectomy could be one of the options for clinical T1N0M0 non-small cell lung cancer located outer third as well as being able to preserve pulmonary function better than lobectomy.Clinical trial registration- Name: Retrospective analysis of segmentectomy and lobectomy for cT1N0M0 non-small cell lung cancer
- Date of approval: February 2014
- Number of IRB approval: 14-003.
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| Keywords: | Lung cancer Segmentectomy Lobectomy Prognosis Pulmonary function |
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