WCLC 2025 - Posters & ePosters-EP.07.13 Thoracoscopic Combined Anatomicalsublobarresection for Deep Intersegmental Small-Sized Non-Small Cell Lung Cancer

EP.07.13 Thoracoscopic Combined Anatomicalsublobarresection for Deep Intersegmental Small-Sized Non-Small Cell Lung Cancer

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This study by YG Sun, Q Zhang, and F Shao from Nanjing Chest Hospital addresses surgical treatment for deep intersegmental small-sized non-small cell lung cancer (DILC), defined as tumors located near intersegmental veins that involve more than one lung segment but not all subsegments of one segment, as identified by advanced imaging (thin-slice and 3D-CT scans).<br /><br />The authors emphasize the importance of achieving sufficient surgical margins (at least 2 cm or a tumor-to-margin ratio of 1.0) while preserving lung function. Accurate localization of nodules and understanding intersegmental planes (ISP) are critical for sublobar resections, although standardized surgical recommendations await more high-level evidence.<br /><br />Nanjing Chest Hospital developed a combined anatomical sublobar resection (CASR) approach based on precise anatomical knowledge and imaging, involving segmentectomy plus subsegmentectomy of adjacent segments. This contrasts with combined non-anatomical extended resection (CNER), which combines segmentectomy with non-anatomical wedge resection of adjacent lung tissue. CASR relies on removing major vascular structures in the affected area, using fluorescence to delineate intersegmental planes and ensuring proper lymph node dissection, aiming for oncological safety and lung function preservation.<br /><br />Comparing outcomes, CASR demonstrated sufficient surgical margins and was associated with a lower risk of local recurrence compared to CNER. Cases of recurrence mainly involved insufficient surgical margins or lymph node involvement. Overall, the study concludes that CASR is a safe, effective, and potentially preferable surgical option for patients with deep intersegmental small-sized NSCLC, offering precise tumor removal and margin adequacy to minimize local recurrence while maximizing lung preservation.

Asset Subtitle

yungang sun

Meta Tag

Speaker yungang sun

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

deep intersegmental lung cancer

non-small cell lung cancer

sublobar resection

combined anatomical sublobar resection

combined non-anatomical extended resection

surgical margins

tumor localization

intersegmental planes

lung function preservation

local recurrence