Frontiers in Oncology (Aug 2023)

Wedge resection vs. segmentectomy for lung cancer measuring ≤ 2 cm with consolidation tumor ratio > 0.25

  • Tetsuya Isaka,
  • Takuya Nagashima,
  • Hiroyuki Adachi,
  • Hiroto Narimatsu,
  • Hiroto Narimatsu,
  • Kotaro Murakami,
  • Shunsuke Shigefuku,
  • Noritake Kikunishi,
  • Naoko Shigeta,
  • Kozue Watabe,
  • Yujin Kudo,
  • Yoshihiro Miyata,
  • Morihito Okada,
  • Norihiko Ikeda,
  • Hiroyuki Ito

DOI
https://doi.org/10.3389/fonc.2023.1253414
Journal volume & issue
Vol. 13

Abstract

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ObjectivesWe aimed to clarify the differences in prognosis between wedge resection and segmentectomy performed for cN0 non-small cell lung cancer (NSCLC) measuring ≤ 2 cm, with consolidation tumor ratio (CTR) > 0.25.MethodsThis multicenter study included 570 patients with cN0 NSCLC (tumor size ≤ 2 cm, CTR > 0.25) who underwent wedge resection (n = 244) and segmentectomy (n = 326) between January 2010 and December 2018. After propensity score matching (PSM, 1:1 method), 182 patients were matched for clinical characteristics (age, sex, laterality, smoking index, tumor size, CTR, carcinoembryonic antigen value, positron-emission tomography-documented maximum standardized uptake value, clinical stage, and tumor disappearance rate) and intergroup comparison of disease-free survival (DFS) and overall survival (OS). Using Gray’s test, an intergroup comparison of the cumulative incidence of lung cancer-specific mortality was performed.ResultsAfter PSM, similar DFS (5-year DFS, 79.9% vs. 87.1%, p = 0.103) and OS (5-year OS, 88.7% vs. 88.9%, p = 0.719) rates were observed in the wedge resection and segmentectomy groups. We observed no significant intergroup differences in lung cancer-specific mortality (5-year cumulative incidence: 4.6% vs. 3.5%; p = 0.235). Subgroup analysis revealed no specific subgroup demonstrating improved DFS or OS after undergoing wedge resection or segmentectomy.ConclusionDFS, OS, and lung cancer-specific mortality were comparable between wedge resection and segmentectomy of cN0 NSCLC—tumor size ≤ 2 cm and CTR > 0.25. Large-scale prospective clinical trials are warranted to compare the prognoses of wedge resection and segmentectomy for these tumors.

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