2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.126 (Poster) PP01.126 Lobectomy versus Sublobar Resection in the population based Mid South Quality of Surgical Resection (MS QSR) Cohort

PP01.126 (Poster) PP01.126 Lobectomy versus Sublobar Resection in the population based Mid South Quality of Surgical Resection (MS QSR) Cohort

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A study conducted by the Thoracic Oncology Research Group and the Baptist Cancer Center in Memphis evaluated the survival outcomes of lobectomy versus sublobar resection in patients with small, peripheral non-small cell lung cancer (NSCLC). The researchers aimed to determine if the findings from two previous randomized clinical trials, which showed equivalent survival between the two procedures in selected patients, could be generalized to a population-based cohort.<br /><br />Using data from the Mid-South Quality of Surgical Resection database, the researchers identified patients who met the eligibility criteria for the CALGB140503 and JCOG0802 trials. They compared the overall survival (OS) between recipients of lobectomy and sublobar resection using Kaplan-Meier plots, log-rank tests, and proportional hazards models.<br /><br />The results showed that sublobar resection was similar to lobar resection in patients who met the trial selection criteria. However, the wedge resection was associated with worse survival in stage IA patients who did not meet the selection criteria. Segmentectomy remained equivalent in this group. Interestingly, only a few recipients of sublobar resection met the selection criteria.<br /><br />In terms of survival outcomes in patients who did not meet the eligibility criteria, lobectomy had better outcomes compared to sublobar resection. Propensity-matched survival analysis also showed similar results, with lobectomy associated with better survival in both CALGB and JCOG ineligible patients.<br /><br />In conclusion, the study suggests that lobectomy is associated with better survival outcomes compared to sublobar resection in patients who do not meet the eligibility criteria for clinical trials. However, in patients who meet the selection criteria, sublobar resection can be considered a viable alternative to lobectomy. Further research is needed to determine the factors influencing the selection of surgical procedures and their impact on long-term outcomes in patients with NSCLC.

Asset Subtitle

Raymond Osarogiagbon

Keywords

Thoracic Oncology Research Group

Baptist Cancer Center

lobectomy

sublobar resection

non-small cell lung cancer

NSCLC

randomized clinical trials

overall survival

Kaplan-Meier plots

proportional hazards models