WCLC 2025 - Posters & ePosters-EP.07.19 Temporal Advances of Surgical Outcomes in Posterior Segment ectomy for Primary Lung Cancer

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This single-institution retrospective study at the National Cancer Center Hospital evaluated temporal changes in surgical outcomes for posterior segmentectomy (S10 and combined S910) in primary non-small cell lung cancer (NSCLC) from 2012 to 2023. Building on prior findings that accumulated expertise improves complex segmentectomy, the study compared two surgical techniques: the traditional interlobar approach and the more recently preferred posterior approach.<br /><br />Ninety-four eligible patients were analyzed, with 32 undergoing the interlobar approach and 62 treated via the posterior approach. Both groups had comparable baseline characteristics regarding age, sex, lung function, tumor size, location, and histology.<br /><br />Key findings showed a transition over time from interlobar to posterior approach for posterior segmentectomy. The posterior approach was associated with a significantly shorter median operation time (106 vs. 116 minutes, p=0.001) and less blood loss (8.5 vs. 17.5 ml, p=0.006). Surgical margin adequacy was similar in both groups, with about 70% achieving margins equal to or exceeding tumor size or 20 mm. Perioperative outcomes—including complications, prolonged air leaks, hospital stay length, and 30-day mortality—were low and comparable between techniques. Five-year overall survival rates were excellent (approximately 97-98%) regardless of approach.<br /><br />The study concludes that the posterior approach has effectively replaced the interlobar approach for posterior segmentectomy, offering reduced operation time and favorable perioperative outcomes without compromising oncological safety. Limitations include its retrospective design, single-center setting, relatively small sample size, and shorter follow-up in the posterior group. Nonetheless, these findings suggest that accumulated surgeon experience and the posterior technique improve the safety and efficiency of complex segmentectomy for small peripheral NSCLC, supporting its wider adoption.

Asset Subtitle

Ryota Kiriyama

Meta Tag

Speaker Ryota Kiriyama

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

posterior segmentectomy

non-small cell lung cancer

NSCLC

interlobar approach

posterior approach

surgical outcomes

operation time

blood loss

perioperative complications

oncological safety