2023 World Conference on Lung Cancer (Posters)-P1.26. Trisegmentectomy is Indicated for Non-Small Cell Lung Cancer in the Left Upper Division

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Trisegmentectomy is a surgical procedure indicated for the treatment of non-small cell lung cancer (NSCLC) in the left upper division of the lung. The left upper lobe consists of two anatomical components: the upper division (apical, posterior, and anterior segments) and the lingula (superior and inferior lingular segments). While left upper division tumors are typically resected by left upper lobectomy (LUL), which involves removing the entire lobe, trisegmentectomy (LU3S) is a lung-sparing approach that spares the lingula.<br /><br />A study was conducted to compare the safety and oncologic efficacy of LU3S and LUL in patients with clinical stage I-IIA NSCLC in the left upper division. The study found that the perioperative outcomes did not differ significantly between LU3S and LUL. Survival analysis showed that overall and recurrence-free survival were comparable between the two procedures, which aligns with previous studies.<br /><br />Subgroup analyses revealed that older patients and those with reduced pulmonary function had improved overall survival after LU3S compared to LUL. This finding suggests that trisegmentectomy may offer a survival benefit for these specific patient populations. Additionally, the study found that overall survival was comparable between LUL and LU3S in patients with pathological stage IA3 and IB disease, expanding the indications for segmentectomy.<br /><br />The study also compared perioperative outcomes and 6-year survival in a propensity score-matched cohort. Patients undergoing LUL had a greater number of lymph nodes sampled compared to LU3S, but there were no other significant differences in perioperative outcomes. Recurrence-free survival was improved after LU3S, but overall survival did not differ between the two procedures.<br /><br />In conclusion, the study suggests that LU3S and LUL are equivalent in terms of short- and long-term outcomes for patients with clinical stage I-IIA NSCLC in the left upper division. Trisegmentectomy may offer advantages in terms of preserving lung function and improving survival in certain subgroups of patients. The study provides evidence to support the use of trisegmentectomy as a viable treatment option for NSCLC in the left upper division.

Asset Subtitle

Paula Ugalde Figueroa

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Speaker Paula Ugalde Figueroa

Topic Early-Stage NSCLC: More Minimally Invasive Approaches

Keywords

Trisegmentectomy

Surgical procedure

Non-small cell lung cancer

NSCLC

Left upper division

Left upper lobe

Lung-sparing approach

Perioperative outcomes

Overall survival

Recurrence-free survival