Adaptation criterion for segmentectomy in small‐sized early stage non‐small cell lung cancer

Abstract

Abstract Background Although the utility of segmentectomy for early‐stage non‐small cell lung cancer (NSCLC) has been reported, the adaptation criterion for segmentectomy is unclear. Methods In total, 171 NSCLC patients who underwent segmentectomy or lobectomy with a consolidation tumor diameter on computed tomography of ≤20 mm were analyzed. Results Consolidation diameter (p = 0.01), consolidation to tumor ratio (CTR) (p < 0.01), maximum standardized uptake value (SUVmax) (p < 0.01), and segmentectomy (p = 0.01) were significantly different upon univariate analysis among patients stratified by recurrence. Positive correlations were observed between the consolidation diameter on CT and CEA (correlation coefficient; r = 0.19, p = 0.01), SUVmax (r = 0.48, p < 0.01), and CTR (r = 0.83, p < 0.01). Because there was a significant correlation among the consolidation diameter of tumors on CT, CTR, and SUVmax in this study, we integrated these factors into one. Consolidation, CTR, and SUVmax (hazard ratio [HR]: 3.77, 95% confidence interval [CI]: 1.35–11.29, p = 0.01) and segmentectomy (HR: 0.24, 95% CI: 0.03–0.90, p = 0.03) were risk factors for recurrence in a multivariate analysis. There was a significant difference between the segmentectomy and lobectomy groups (5‐year relapse‐free survival [RFS] 96.5% vs. 80.7%, p = 0.02). Conclusions Consolidation tumor diameter on CT, CTR, and SUVmax is a risk factor for recurrence. These results suggest that for patients with small‐sized early stage NSCLC, this combined factor is important for determining the indication for segmentectomy.

Keywords

• consolidation to tumor ratio
• early stage
• non‐small cell lung cancer
• segmentectomy
• standardized uptake value