WCLC 2025 - Posters & ePosters-P1.07.21 Lobectomy Versus Multi-Segmentectomy for Left Upper Lobe Lung Cancer: A Propensity Score-Matched Analysis

P1.07.21 Lobectomy Versus Multi-Segmentectomy for Left Upper Lobe Lung Cancer: A Propensity Score-Matched Analysis

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This study compared lobectomy (L-group) and multi-segmentectomy (S-group) for patients with left upper lobe lung cancer, aiming to evaluate whether multi-segmentectomy offers comparable long-term outcomes. The left upper lobe includes the upper division and lingual segments, structurally similar to the right upper lobe and middle lobe. Data from 247 patients (191 lobectomy, 56 multi-segmentectomy) treated between 2011 and 2017 at two institutions were analyzed. After excluding patients who received neoadjuvant therapy or had stage IV disease, propensity score matching (PSM) was used to balance baseline characteristics including age, gender, smoking history, tumor site, size, consolidation-to-tumor ratio (CTR), SUVmax, and clinical nodal status, resulting in 53 matched pairs.<br /><br />Before matching, the lobectomy group had more advanced tumors, but after adjustment, no significant differences were found in 5-year overall survival (OS) or recurrence-free survival (RFS) between the groups: OS was 93.7% for lobectomy versus 87.9% for multi-segmentectomy, and RFS was 85.6% versus 85.3%, respectively. Recurrence patterns, including local and distant metastases, showed no significant differences, and no recurrences occurred at resection margins in either group. A subgroup analysis focusing on tumors ≤2 cm with CTR ≤0.5 also revealed no significant differences in survival outcomes.<br /><br />Prior studies suggested segmentectomy carries a slightly higher local recurrence risk and was generally limited to small peripheral tumors. However, this study found that multi-segmentectomy provides comparable prognosis to lobectomy even beyond conventional early-stage indications. The findings support that multi-segmentectomy is a feasible surgical option for left upper lobe lung cancer, potentially applicable to a wider range of patients without compromising long-term outcomes.

Asset Subtitle

Naoki Takeno

Meta Tag

Speaker Naoki Takeno

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

lobectomy

multi-segmentectomy

left upper lobe lung cancer

long-term outcomes

propensity score matching

overall survival

recurrence-free survival

tumor size

consolidation-to-tumor ratio

surgical treatment