Thoracoscopic segmentectomy versus lobectomy: A propensity score–matched analysis

Commentary: Anatomic segmentectomy: The exception, not the rule

“…With regards to perioperative morbidity, however, we have already seen from early analyses of JCOG0802 that the rate of postoperative air leak and recurrent chest drainage is greater in the complex segmentectomy cohort. 4 This is not terribly surprising, based on the differences in surgical technique creating the fissure; however, it does contradict the results from this study by Sesma and colleagues 3 …”

“…With regards to perioperative morbidity, however, we have already seen from early analyses of JCOG0802 that the rate of postoperative air leak and recurrent chest drainage is greater in the complex segmentectomy cohort. 4 This is not terribly surprising, based on the differences in surgical technique creating the fissure; however, it does contradict the results from this study by Sesma and colleagues 3 Apart from medically comorbid patients and those with marginal lung function, segmentectomy should be reserved for patients with node-negative, small tumors with favorable radiographic characteristics in cases in which an adequate resection margin is attainable. For the time being, segmentectomy remains the exception rather than the rule.…”

“…Randomized, prospective data remain elusive, although trials are in progress. 1 , 2 Sesma and colleagues 3 add to the growing body of literature that advocates the use of anatomic segmentectomy for the curative resection of early-stage non–small cell lung cancer (NSCLC).…”

“…In this publication, Sesma and colleagues 3 imply that sublobar resections in the form of anatomic segmentectomies may be oncologically equivalent operations to lobectomies for resectable NSCLC with fewer postoperative prolonged air leaks. The authors drew from a cohort of 2250 patients with early-stage NSCLC from 33 centers in Spain over a 15-month period, of whom 2070 received lobectomy and 180 segmentectomy.…”

“…This tendency is again evident in this study from Sesma and colleagues. 3 Adequate lymph node sampling, at a minimum, is vital to informing decisions in postoperative therapy.…”