WCLC 2025 - Posters & ePosters-EP.07.24 Study on Complex Segmentectomy Cases at Our Institution

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This study by Nagashima et al. at Kanagawa Cancer Center analyzed perioperative outcomes and early prognosis of complex versus simple segmentectomy in lung cancer surgery. Segmentectomy, a lung tissue-sparing surgery, is increasingly used for early-stage lung cancer, though complex segmentectomy—resecting multiple segments or subsegments—is more technically demanding than simple segmentectomy, which involves a single segment.<br /><br />Between 2017 and 2024, 777 patients undergoing video-assisted thoracoscopic segmentectomy were retrospectively reviewed. Cases were categorized as simple (309 cases, 40%) or complex segmentectomy (468 cases, 60%). Complex segmentectomy was common in both lung cancer (61%) and metastatic lung tumor cases (58%), with an increasing trend over time. Tumors in the complex group were slightly smaller (1.8 cm vs. 2.0 cm), but patient age, smoking history, and lung function were similar between groups.<br /><br />The complex segmentectomy group experienced a modestly longer operative time (160 vs. 150 minutes) but shorter chest tube duration (2.4 vs. 2.6 days). There were no significant differences in intraoperative blood loss or rates of serious postoperative complications, prolonged air leak, or interventions like pleurodesis. Lung cancer cases (cT1N0) showed no significant differences in cumulative recurrence-free survival between groups.<br /><br />The authors conclude that although complex segmentectomy requires slightly longer surgery, it does not increase complications or adversely affect short-term prognosis compared to simple segmentectomy. Given its feasibility and oncological safety, complex segmentectomy is an acceptable surgical choice when required for tumor localization and margin control. This large cohort study corroborates previous smaller studies, supporting complex segmentectomy as a safe approach in early-stage lung cancer management.

Asset Subtitle

Takuya Nagashima

Meta Tag

Speaker Takuya Nagashima

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

complex segmentectomy

simple segmentectomy

lung cancer surgery

perioperative outcomes

early prognosis

video-assisted thoracoscopic surgery

lung tissue-sparing surgery

operative time

postoperative complications

recurrence-free survival