2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.126 Raymond Osarogiagbon Abstract

PP01.126 Raymond Osarogiagbon Abstract

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This study evaluated the survival outcomes of lobectomy versus sublobar resection in patients with small, peripheral non-small cell lung cancer (NSCLC) in a population-based cohort. The researchers used data from the Mid-South Quality of Surgical Resection (MS-QSR) database from 2009 to 2023.<br /><br />The study included a total of 3,310 patients, with 2,914 (88%) undergoing lobectomy and 396 (12%) undergoing sublobar resections. The patients were divided into subgroups based on their eligibility for two randomized clinical trials, CALGB140503 and JCOG0802.<br /><br />The findings showed that in the eligible cohorts, overall survival (OS) was similar between lobectomy and sublobar resection. The 5-year OS rates were 74% for lobectomy and 68% for sublobar resection in the CALGB-eligible cohort, and 75% for lobectomy and 74% for sublobar resection in the JCOG-eligible cohort.<br /><br />However, among patients who did not meet the eligibility criteria for the clinical trials, lobectomy was associated with better OS in the CALGB-ineligible stage IA cohort but not in the JCOG-ineligible cohort. Propensity-matched analysis further supported these findings, with lobectomy showing better survival outcomes compared to sublobar resection in the CALGB-ineligible patients, but not in the JCOG-ineligible patients.<br /><br />The study also found that the majority of sublobar resections did not meet the selection criteria for the clinical trials. Wedge resection was associated with worse survival outcomes in CALGB-ineligible stage IA patients, while segmentectomy remained equivalent.<br /><br />In conclusion, the study suggests that sublobar resection is comparable to lobectomy in patients who meet the selection criteria for clinical trials. However, wedge resection may be associated with worse survival outcomes in CALGB-ineligible stage IA patients. It also highlights the limited number of patients who meet the criteria for sublobar resection.

Keywords

lobectomy

sublobar resection

small peripheral non-small cell lung cancer

survival outcomes

population-based cohort

randomized clinical trials

overall survival

eligibility criteria

wedge resection

segmentectomy