2024 World Conference on Lung Cancer (WCLC) - Posters-P2.07B.02 Is Wedge Resection Really Enough for the Treatment of Patient with Stage I Non-Small Cell Lung Cancer? A SEER Database Analysis.

P2.07B.02 Is Wedge Resection Really Enough for the Treatment of Patient with Stage I Non-Small Cell Lung Cancer? A SEER Database Analysis.

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The study titled "Is Wedge Resection Really Enough for the Treatment of Patients with Stage I Non-Small Cell Lung Cancer? A SEER Database Analysis" by Luigi Ventura et al. analyzes the effectiveness of wedge resection versus lobectomy in treating patients with Stage I Non-Small Cell Lung Cancer (NSCLC). Using data from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2017, the research investigates overall survival (OS) and lung cancer-specific survival (LCSS) among patients undergoing these surgical treatments.<br /><br />The analysis involved 32,673 patients who had lobectomies and 9,073 who underwent wedge resections. After propensity score matching, 4,764 patients from each group were compared. The findings suggest that lobectomy generally provides superior OS and LCSS compared to wedge resection, except for patients with Stage IA1, whose outcomes were similar in both treatments.<br /><br />The hazard ratios for different cancer stages indicated that lobectomy improves survival for most groups: Stage IA2 (HR: 0.82), Stage IA3 (HR: 0.65), and Stage IB (HR: 0.80) all showed significant outcomes favoring lobectomy. However, when a similar number of lymph nodes (10 or more) were removed, the survival advantage of lobectomy diminished for certain stages.<br /><br />Regarding perioperative mortality, the study found that wedge resection had a higher 30-day mortality rate compared to lobectomy (2.3% vs. 1.4%), but no significant difference in 90-day mortality rates (4.5% vs. 3.7%).<br /><br />In conclusion, while early clinical trials suggested equal efficacy between wedge resection and lobectomy for small tumors (≤2 cm), this study finds lobectomy to be more effective for specific stages (IA3 and IB). The findings support lobectomy as a preferable treatment in these cases, particularly when adequate lymph node dissection is performed.

Asset Subtitle

Luigi Ventura

Meta Tag

Speaker Luigi Ventura

Topic Early-Stage NSCLC

Keywords

wedge resection

lobectomy

Stage I NSCLC

SEER database

overall survival

lung cancer-specific survival

hazard ratios

lymph node dissection

perioperative mortality

Luigi Ventura