2024 World Conference on Lung Cancer (WCLC) - Posters-P2.07B.06 Segmentectomy for cIA1-2 Lung Cancer in the Lower Lobe with Solid-Predominant Opacity: Impact on Recurrence and Survival Rates

P2.07B.06 Segmentectomy for cIA1-2 Lung Cancer in the Lower Lobe with Solid-Predominant Opacity: Impact on Recurrence and Survival Rates

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This study analyzed the outcomes of segmentectomies performed for stage cIA1-2 non-small cell lung cancer (NSCLC) with solid-predominant opacity in the lower lobe, particularly focusing on comparing the S6 segment to other basal segments. The JCOG0802/WJOG4607L trial indicated that segmentectomy might not offer a significant survival advantage over lobectomy for NSCLC. This investigation aimed to delve deeper into the impact of lower lobe segmentectomies.<br /><br />Surgical nuances from 89 patients who underwent segmentectomy from 2010 to 2022 at two Japanese institutions were scrutinized, excluding basal segmentectomies, for primary lung cancer in categories cIA1-IA2, less than 2 cm in size, and with a consolidation-to-tumor (C/T) ratio of 0.5. Data on surgical approaches, complications, and perioperative outcomes were gathered, and long-term survival rates were assessed.<br /><br />Findings suggested that patients undergoing S6 segmentectomy displayed poorer overall survival (5-year OS of 79.3%), recurrence-free survival (5-year RFS of 74.2%), and lung cancer-specific survival compared to those operated on other basal segments (with 5-year OS and RFS rates of 92.3% and 87.5%, respectively). Recurrence analysis indicated a notably higher incidence of locoregional and distant recurrence in the S6 segment group.<br /><br />The study highlighted limitations, such as potential biases due to the retrospective approach and a small sample size, impacting statistical power. The authors recommended vigilance when selecting segmentectomy for S6 lesions due to the heightened risk of recurrence and diminished survival rates, contrasting with better outcomes in non-S6 basal segments. Overall, these findings offer critical insights into surgical decisions regarding lower lobe segmentectomies in early-stage lung cancer and underline the need for further large-scale studies to validate these observations.

Asset Subtitle

Makoto Endo

Meta Tag

Speaker Makoto Endo

Topic Early-Stage NSCLC

Keywords

segmentectomy

non-small cell lung cancer

NSCLC

lower lobe

S6 segment

surgical outcomes

recurrence

survival rates

JCOG0802/WJOG4607L trial

lung cancer