Systematic review and meta-analysis of video-assisted thoracoscopic surgery segmentectomy versus lobectomy for stage I non–small cell lung cancer

Abstract

Background: Whether video-assisted thoracoscopic surgery (VATS) segmentectomy and VATS lobectomy provide similar perioperative and oncological outcomes in stage I non-small cell lung cancer (NSCLC) is still controversial. Methods: Meta-analysis of 12 studies comparing outcomes after VATS lobectomy and VATS segmentectomy for stage I NSCLC. Data were analyzed by the RevMan 5.3 software. Results: Disease-free survival (HR 1.19, 95% CI 0.89 to 1.33, P = 0.39), overall survival (HR 1.11, 95% CI 0.89 to 1.38, P = 0.36), postoperative complications (OR = 1.10, 95% CI 0.69 to 1.75, P = 0.7), intraoperative blood loss (MD = 3.87, 95% CI − 10.21 to 17.94, P = 0.59), operative time (MD = 10.89, 95% CI − 13.04 to 34.82, P = 0.37), air leak > 5 days (OR = 1.20, 95% CI 0.66 to 2.17, P = 0.55), and in-hospital mortality (OR = 1.67, 95% CI 0.39 to 7.16, P = 0.49) were comparable between the groups. Postoperative hospital stay (MD = − 0.69, 95% CI − 1.19 to − 0.19, P = 0.007) and number of dissected lymph nodes (MD = − 6.44, 95%CI − 9.49 to − 3.40, P < 0.0001) were significantly lower in VATS segmentectomy patients. Conclusions: VATS segmentectomy and VATS lobectomy provide similar oncological and perioperative outcomes for stage I NSCLC patients. This systematic review was registered on PROSPERO and can be accessed at http://www.crd.york.ac.uk/PROSPERO/ display_record.php?ID = CRD42019133398.

Understanding the Impact of Histology on the Post-Surgery Prognosis for Patients 70 Years and Older With I A Stage Non-Small Lung Cancer

“…Furthermore, the question whether the limited resection is suitable for early-stage NSCLC remains to be investigating, and lobectomy is still the standard treatment for early-stage NSCLC according to National Comprehensive Cancer Network (NCCN) guidelines. However, there is emerging evidence from retrospective studies supporting that subloar resection suitable for certain early-stage NSCLC [26][27][28][29]. In our study, we found that SR yielded similar OS compared to LT for LUAD patients with TS ≤ 10 mm, and In addition, we found that advanced tumor grade was signi cantly associated with poorer OS and LCSS in elderly LUAD patients; while in LSQCC, the difference was not signi cant.…”

Lobectomy Versus Segmentectomy in Patients with Stage T (&gt;2 cm and ≤3 cm) N0M0 Non-small Cell Lung Cancer: A Propensity Score Matching Study

“…With the popularization of low-dose computed tomography (LDCT) for lung cancer screening, the detection rate for patients with early lung cancer has improved [7], and segmentectomy is more widely used as a surgical treatment. Recent studies have shown that NSCLC patients that received segmentectomies for lesions < 2 cm had similar oncologic effects compared with those that received lobectomies [8,9,10,11]. Patients receiving segmentectomies also had more protected lung function [12,13].…”

Prognosis of segmentectomy in the treatment of stage IA non‑small cell lung cancer (Review)

“…The duration of hospital stay following surgery is significantly shorter in some patients with VATS segmentectomy. For patients who can tolerate a lobectomy, anatomical segmentectomy resection is associated with faster postoperative recovery ( 29 ). This might be because patients who undergo VATS segmentectomy can achieve lung recruitment faster, allowing a shorter recovery before lung function returns to optimal levels ( 30 ).…”