WCLC 2025 - Posters & ePosters-EP.07.05 Oncologic Outcomes of Segmentectomy Versus Lobectomy in Early-Stage Lung Adenocarcinoma With High-Risk Pathologic Features

EP.07.05 Oncologic Outcomes of Segmentectomy Versus Lobectomy in Early-Stage Lung Adenocarcinoma With High-Risk Pathologic Features

Back to course

Pdf Summary

This retrospective single-center study evaluated oncologic outcomes of segmentectomy versus lobectomy in clinically early-stage (stage IA) lung adenocarcinoma (LUAD) patients exhibiting high-risk pathologic features—defined as visceral pleural invasion, lymphovascular invasion, spread through airspaces, or poor differentiation. The study excluded patients with occult nodal metastasis and included 1,137 patients treated between 2016 and 2020, with 930 undergoing lobectomy and 207 segmentectomy.<br /><br />Using propensity score matching and inverse probability weighting to mitigate selection bias, the researchers compared cumulative incidence of recurrence (CIR) and lung cancer-specific cumulative incidence of death (LC-CID) between the two surgical groups. Across unmatched, matched, and weighted cohorts, no statistically significant differences were found in 5-year CIR or LC-CID rates between segmentectomy and lobectomy patients. For example, in the matched cohort, the 5-year CIR was 9.1% for segmentectomy and 7.6% for lobectomy (hazard ratio [HR] 0.82; p=0.57). Similarly, LC-CID did not differ significantly in any analysis.<br /><br />These findings support that segmentectomy yields comparable oncologic outcomes to lobectomy in early-stage LUAD patients with high-risk pathological features. This suggests that for patients with small tumors but adverse pathologic characteristics, segmentectomy remains a feasible surgical option, potentially preserving more lung tissue without compromising cancer control. The study contributes important clinical evidence reinforcing the viability of lung-sparing surgery even in the context of higher-risk tumor biology.

Asset Subtitle

Zhifei Li

Meta Tag

Speaker Zhifei Li

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

segmentectomy

lobectomy

early-stage lung adenocarcinoma

high-risk pathological features

visceral pleural invasion

lymphovascular invasion

spread through airspaces

poor differentiation

oncologic outcomes

lung-sparing surgery