Comparison of surgical outcomes and prognosis between wedge resection and simple Segmentectomy for GGO diameter between 2 cm and 3 cm in non-small cell lung cancer: a multicenter and propensity score matching analysis

Abstract

Abstract Background As segmentectomy had become commonly used for Non-Small Cell Lung Cancer (NSCLC) treatment, which had the advantages of radical operation, however, it remains controversial owing to procedural complexity and risk of increased complications compared with wedge resection. We evaluated operative and postoperative outcomes of simple segmentectomy compared to wedge resection in ground-glass opacity (GGO) diameter between 2 cm and 3 cm NSCLC. Methods We retrospectively reviewed 1600 clinical GGO diameter between 2 cm and 3 cm NSCLC patients who received simple segmentectomy and wedge resection between Jan 2011 and Jan 2015. Participants were matched 1:1 on their propensity score for two groups. Clinic-pathologic, operative, and postoperative results of two groups were compared. Results After using propensity score methods to create a matched cohort of participants with simple segmentectomy group similar to that wedge resection, there were no significant differences detected in tumor size, margin distance, histology, age, sex, preoperative comorbidities and preoperative pulmonary function. Overall complications in simple segmentectomy group were more than wedge resection group (21% vs 3%, p = 0.03). Median operative time (110.6 vs. 71.2 min; p = 0.01) and prolonged air leakage (12% vs. 3%; p = 0.02) was significantly longer in the simple segmentectomy group. There was no difference in recurrence free survival (RFS) and overall survival (OS) of 5-years between simple segmentectomy group and wedge resection group. Postoperative pulmonary function in simple segmentectomy group recovered more slowly than wedge resection group. Conclusion Wedge resection may have comparable efficacy as simple segmentectomy for GGO diameter between 2 cm and 3 cm NSCLC, but lead to less complications, less surgical procedure and faster recovery of pulmonary function.

Keywords

• NSCLC
• Segmentectomy
• Wedge resection
• Ground-glass opacity
• Propensity score matching