WCLC 2025 - Posters & ePosters-EP.07.27 Unravelling Sublobar Resections: Real-World Outcomes after Wedge vs Segmentectomy and Recurrence Risk Factors

EP.07.27 Unravelling Sublobar Resections: Real-World Outcomes after Wedge vs Segmentectomy and Recurrence Risk Factors

Pdf Summary

This retrospective single-institution study from Ramon y Cajal University Hospital (Madrid, Spain) compared long-term outcomes between segmentectomy and wedge resection—both sublobar surgeries—for clinical stage 0-IA non-small cell lung cancer (NSCLC) from 2018 to 2022, with follow-up through 2024. The study excluded large cell carcinomas and carcinoid tumors, analyzing 127 patients (87 segmentectomy, 40 wedge).<br /><br />Key clinical and pathological characteristics showed segmentectomy patients were younger with better lung diffusion capacity. Segmentectomy samples had significantly more lymphadenectomies and lymph node sampling. Tumor size, histology, and PD-L1 expression rates were similar between groups, although EGFR mutations appeared only in segmentectomy patients.<br /><br />Survival analysis revealed no statistically significant differences in overall survival or cumulative recurrence incidence between wedge and segmentectomy groups. Multivariate analysis identified independent risk factors for recurrence including lymphatic invasion, positive PD-L1 expression, presence of micropapillary and solid adenocarcinoma patterns, and ALK and KRAS mutations. Notably, ALK mutation was strongly associated with increased recurrence risk. Age was also a predictor of locoregional recurrence.<br /><br />These data suggest that, in a real-world clinical setting, segmentectomy and wedge resection provide comparable OS and recurrence outcomes for early-stage NSCLC. Molecular features such as ALK and KRAS mutations and tumor histology patterns significantly influence recurrence risk regardless of surgical technique.<br /><br />Limitations include the retrospective design, single-center cohort, and relatively small sample size which may affect generalizability.<br /><br />In summary, both sublobar resections appear equivalent for early-stage NSCLC, but attention to molecular and pathological recurrence risk factors is critical to optimize patient management and surveillance strategies following surgery.

Asset Subtitle

Sara Fra

Meta Tag

Speaker Sara Fra

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

segmentectomy

wedge resection

non-small cell lung cancer

NSCLC

early-stage lung cancer

lymphadenectomy

PD-L1 expression

ALK mutation

KRAS mutation

recurrence risk