Comparison between a Case-Matched Analysis of Left Upper Lobe Trisegmentectomy and Left Upper Lobectomy for Small Size Lung Cancer Located in the Upper Division

Iwasaki, Atsushi; Hamanaka, Wakako; Hamada, Tatsuro; Hiratsuka, Masafumi; Yamamoto, Satoshi; Shiraishi, Taizo; Shirakusa, Takayuki

doi:10.1055/s-2007-965406

Cited by 29 publications

(12 citation statements)

References 14 publications

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“…Recently, Witte et al 12 reported the results of a pair matched control study of 66 patients affected by NSCLC comparing lobectomies and multi-segmentectomies; in their experience, the median diameter of the tumor was similar to ours, but they also considered patients with positive node involvement; although authors did not report analysis of outcomes according to the pathological stage, they did not find differences in terms of neither survival nor recurrence rate between the two types of procedures. Consequently, authors conclude that multi-segmentectomies can be an oncologically safe procedures for NSCLC and they define left upper lobectomy as a possible overtreatment for some patients; the same similar conclusions are shared by two others studies by Soukiasian 29 and Iwasaki 30 ; both studies were focused on stage I tumors only. In our study, oncological outcomes in the two groups were comparable and no difference in both overall survival (P = 0.825) and disease-free interval (P = 0.565) were found; furthermore, both univariate and multivariate analyses of OS and DFI confirmed that procedure (lobectomy vs multi-segmentectomy) was not a significant prognostic factor.…”

Section: Discussionsupporting

confidence: 60%

Is left upper lobectomy always worthwhile for early stage lung cancer? A comparison between left upper lobectomy, trisegmentectomy, and lingulectomy

Aprile

Bertoglio

Dini

et al. 2017

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 60%

Is left upper lobectomy always worthwhile for early stage lung cancer? A comparison between left upper lobectomy, trisegmentectomy, and lingulectomy

Aprile

Bertoglio

Dini

et al. 2017

Journal of Surgical Oncology

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“…One of the key findings of the present study was that the numbers of CTCs in patients with SPNs that were early-stage NSCLC were associated with the location of the nodule in the upper lobe of the lung and the age of the patients but not the type of nodule or the pathological type. Thus, lung cancer is more commonly identified in the upper lobe of the lung [32]. However, the underlying mechanism requires further functional investigations.…”

Section: Discussionmentioning

confidence: 99%

The combination of CTCs and CEA can help guide the management of patients with SPNs suspected of being lung cancer

et al. 2020

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Objective: Solitary pulmonary nodules (SPNs) is a common radiographic finding and require further evaluation because of the possibility of lung cancer. This study aimed to determine the sensitivity and specificity of circulating tumour cells (CTCs) as a marker for the diagnosis of SPNs and the integration of CTCs, carcinoembryonic antigen (CEA) and imaging findings to improve the sensitivity and specificity of diagnosis in patients with SPNs suspected of being lung cancer. Method: For the serum biomarker assay, the concentration of CEA was measured by an automated electrochemiluminescence analyzer. CTCs were collected from 6 ml of blood by the SE i-FISH method, which detects the gene copy number in eight chromosomes and the tumour-associated antigen CK18. Results: With a threshold of 6 CTC units, the method showed a sensitivity of 67.1% and a specificity of 56.5% in the diagnosis of NSCLC, especially in the upper lobe, in which the diagnostic strength was the highest (P < 0.01). CTCs, CEA and nodule type had the highest diagnostic efficacy (area under the curve, 0.827; 95% confidence interval, 0.752-0.901) in patients with SPNs being suspected lung cancer. Combining CTCs (cut-off value 12 units) with CEA (1.78 ng/ml), the method showed a sensitivity of 77.8% and a specificity of 90% in the diagnosis of NSCLC, especially in the upper lobe, subsolid nodules and nodules ≥8 mm. Conclusions: Our results demonstrated that CTCs are feasible diagnostic biomarkers in patients with SPNs, especially in the upper lobe. Furthermore, CTCs combined with CEA showed higher diagnostic efficacy in the upper lobe, subsolid nodules and nodules ≥8 mm.

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“…Although thoracoscopic lobectomy has achieved increased safety and utilization over the past several years, thoracoscopic segmentectomy has merely been superficially mentioned in the literature [3]. In a case matched study [20], it was described that left upper trisegmentectomy may be a suitable standard treatment if the tumor is small and the suspected margins are well away from the lingula.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of video-assisted thoracoscopic surgery segmentectomy for selected peripheral lung carcinomas☆

Watanabe

Ohori

Nakashima

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Objective: Segmentectomy for non-small cell lung cancer (NSCLC) is believed to increase the rates of recurrence and postoperative air leak. We sought to present our clinical data and outcome of VATS (video-assisted thoracoscopic surgery) segmentectomies with systematic node dissection for selected NSCLC patients. Methods: Inclusion criteria were clinical T1N0M0 peripheral NSCLC measuring 2 cm (n = 38) and NSCLC with interlobar invasion, which cause positive surgical margin with malignancy after lobectomy of a primary lesion and only partial resection of invasion site (n = 3). Outcome variables include hospital course, complications, mortality, recurrence patterns and survival. The intersegmental border was identified using the intersegmental veins as landmark and the demarcation between the resected (inflated) and preserved (collapsed) lungs. The intersegmental plane was divided by an endoscopic stapler and electrocautery. Results: The mean operative time and intraoperative bleeding were 220 min (range 100-306) and 183 ml (30-730), respectively. The number of stapler cartridges used for intersegmental division was 2 (1-5). Postoperative air leak (>7 days), which required no surgical intervention, occurred in two patients. The chest tube drainage duration was 3 days. There were no in-hospital deaths. The numbers of resected subsegments and reserved subsegments in comparison with lobectomy were 5 (2-13) and 5 (3-13), respectively. The FEV1.0 after VS was higher than the predictive FEV1.0 after lobectomy, if the latter was performed as standard procedure. We experienced four cases of distant metastasis after segmentectomy, but there was no case of local recurrence. The 5-year survival and recurrence-free survival rates in pathological stage IA NSCLC were 89.9% and 93.3%, respectively. Conclusions: VATS segmentectomy with systematic node dissection is a reasonable treatment option for selected peripheral NSCLC. #

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Comparison between a Case-Matched Analysis of Left Upper Lobe Trisegmentectomy and Left Upper Lobectomy for Small Size Lung Cancer Located in the Upper Division

Abstract: LTS may be suitable as a standard treatment if the tumor is small and the suspected margins are well away from the lingula.

Cited by 29 publications

References 14 publications

Is left upper lobectomy always worthwhile for early stage lung cancer? A comparison between left upper lobectomy, trisegmentectomy, and lingulectomy

Is left upper lobectomy always worthwhile for early stage lung cancer? A comparison between left upper lobectomy, trisegmentectomy, and lingulectomy

The combination of CTCs and CEA can help guide the management of patients with SPNs suspected of being lung cancer

Feasibility of video-assisted thoracoscopic surgery segmentectomy for selected peripheral lung carcinomas☆

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