Journal of the Formosan Medical Association = Taiwan yi zhi · 2025
Long-term prognosis of complex versus simple segmentectomy for stage I non-small cell lung cancer.
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Teng Hsiang, Huang Hsu-Kai, Ko Kai-Hsiung, Huang Tsai-Wang
Аннотация
BACKGROUND: This study compared the long-term outcomes of complex versus simple segmentectomy in patients with stage I non-small cell lung cancer (NSCLC), focusing on disease-free survival (DFS) and overall survival (OS). With advances in early cancer detection, the role of complex segmentectomy for small, early-stage tumors warrants evaluation.
METHODS: We retrospectively reviewed patients with clinical stage I NSCLC who underwent anatomical segmentectomy from 2007 to 2019 at the Tri-Service General Hospital in Taiwan. Procedures were categorized as complex or simple segmentectomy according to the number and anatomical configuration of resected segments. Clinicopathologic features, perioperative outcomes, and long-term oncologic results were compared. DFS and OS were analyzed using Kaplan-Meier estimates and compared by the log-rank test.
RESULTS: Among 362 patients, 154 underwent simple segmentectomy and 208 underwent complex segmentectomy. Baseline demographic and tumor characteristics were similar between groups. There were no significant differences in DFS (log-rank P = 0.249) and OS (log-rank P = 0.457) at three and five years between the groups. Between the groups, complex segmentectomy yielded a higher median number of dissected lymph nodes, particularly from the N2 station, while operative time, tumor locations, and complication rates were comparable.
CONCLUSION: With the aid of precise preoperative imaging simulation, localization techniques, and intraoperative guidance, complex segmentectomy achieves long-term outcomes equivalent to those of simple segmentectomy for early-stage NSCLC.
METHODS: We retrospectively reviewed patients with clinical stage I NSCLC who underwent anatomical segmentectomy from 2007 to 2019 at the Tri-Service General Hospital in Taiwan. Procedures were categorized as complex or simple segmentectomy according to the number and anatomical configuration of resected segments. Clinicopathologic features, perioperative outcomes, and long-term oncologic results were compared. DFS and OS were analyzed using Kaplan-Meier estimates and compared by the log-rank test.
RESULTS: Among 362 patients, 154 underwent simple segmentectomy and 208 underwent complex segmentectomy. Baseline demographic and tumor characteristics were similar between groups. There were no significant differences in DFS (log-rank P = 0.249) and OS (log-rank P = 0.457) at three and five years between the groups. Between the groups, complex segmentectomy yielded a higher median number of dissected lymph nodes, particularly from the N2 station, while operative time, tumor locations, and complication rates were comparable.
CONCLUSION: With the aid of precise preoperative imaging simulation, localization techniques, and intraoperative guidance, complex segmentectomy achieves long-term outcomes equivalent to those of simple segmentectomy for early-stage NSCLC.