Thoracoscopic Wedge Resection Versus Segmentectomy for cT1N0 Lung Adenocarcinoma

Chiang, Xu-Heng; Lu, Tzu-Pin; Hsieh, Min‐Shu; Tsai, Tsung Han; Liao, Hsien-Chi; Kao, Tzu-Ning; Chang, Chun-Lung; Lin, Mong-Wei; Hsu, Hsao-Hsun; Chen, Jin‐Shing

doi:10.1245/s10434-021-10213-9

Cited by 19 publications

(12 citation statements)

References 33 publications

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“…This nding aligns with previously reported research. 9,12,13 Compared to previous reports, our study has several strengths. First, our research was patient-centered, relying on PROs for more sensitive data that can uncover direct differences between the two surgical modalities.…”

Section: Discussionmentioning

confidence: 91%

Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer

ZHAO,

LIU,

GAO

et al. 2023

Preprint

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Background: Analysis of patient-reported outcomes (PROs) offers valuable insights into distinguishing the effects of closely related medical procedures from the patient’s perspective. In this study we compared symptom burden in patients undergoing uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small cell lung cancer (NSCLC). Methods: The study extracted patients with peripheral NSCLC in a prospective cohort (CN-PRO-Lung 3) who underwent segmentectomy or wedge resection with tumor diameter ≤ 2 cm and consolidation tumor ratio (CTR) ≤ 0.5. PROs data were collected using the Perioperative Symptom Assessment for Lung Surgery questionnaire pre-operatively, daily post-surgery up to the fourth hospitalization day, and weekly post-discharge up to the fourth week. Propensity score matching and a generalized estimation equation model were employed to compare symptom severity and short-term clinical outcomes. Results:In total, 286 patients (82.4%) undergoing segmentectomy and 61 patients (17.6%) undergoing wedge resection were extracted from the cohort. No statistically significant differences were found in the proportion of moderate-to-severe scores for pain, cough, shortness of breath, disturbed sleep, fatigue, drowsiness, and distress during the 4-day postoperative hospitalization or the 4-week post-discharge period before or after matching (all p > 0.05). Compared with segmentectomy, wedge resection showed better short-term clinical outcomes, including shorter operative time (p = 0.001), less intraoperative bleeding (p= 0.046), and lower total hospital costs (p= 0.002). Conclusions: Uniportal thoracoscopic segmentectomy and wedge resection seems to exert similar early postoperative symptom burden for patients with peripheral NSCLC (tumor diameter ≤ 2 cm and CTR ≤ 0.5).

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Section: Discussionmentioning

confidence: 91%

Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer

ZHAO,

LIU,

GAO

et al. 2023

Preprint

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“…Moreover, for nearly two decades, wedge resection has been considered to have a worse prognosis than segmentectomy as surgical technology has developed. Several recently published studies have shown that wedge resection and segmentectomy are equally effective in early-stage NSCLC patients [ 27 ]. In recent years, for early-stage NSCLC patients with surgical contraindications, radiofrequency ablation, thermal ablation and cryoablation have been shown to be efficient treatments for improving patient prognosis [ 5 , 6 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment strategies for stage IA non-small cell lung cancer: A SEER-based population study

Wu,

Zhang,

Feng

et al. 2024

PLoS ONE

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Background There are various therapeutic methods for treating stage IA (T1N0M0) non-small cell lung cancer (NSCLC), but no studies have systematically assessed multiple treatments to determine the most effective therapy. Methods Stage IA NSCLC patient data collected between 2004 and 2018 were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. Treatment modalities included observation, chemotherapy alone (CA), radiation alone (RA), radiation+chemotherapy (RC), surgery alone (SA), surgery+chemotherapy (SC), surgery+radiation (SR) and surgery+radiation+chemotherapy (SRC). Comparisons were made of overall survival (OS) and lung cancer-specific survival (LCSS) among patients based on different therapeutic methods by survival analysis. Results Ultimately, 89147 patients with stage IA NSCLC between 2004 and 2018 were enrolled in this study. The order of multiple treatment modalities based on the hazard ratio (HR) for OS for the entire cohort revealed the following results: SA (HR: 0.20), SC (HR: 0.25), SR (HR: 0.42), SRC (HR: 0.46), RA (HR: 0.56), RC (HR: 0.72), CA (HR: 0.91) (P<0.001), and observation (HR: Ref). The SA group had the best OS and LCSS, and similar results were found in most subgroup analyses (all P<0.001). The order of surgical modalities based on the HR for OS for the entire cohort revealed the following results: lobectomy (HR: 0.32), segmentectomy (HR: 0.41), wedge resection (HR: 0.52) and local tumor destruction (HR: Ref). Lobectomy had the best effects on OS and LCSS, and similar results were found in all subgroup analyses (all P<0.001). Conclusion SA appeared to be the optimal treatment modality for patients with stage IA NSCLC, and lobectomy was associated with the best prognosis. There may be some indication and selection bias in our study, and the results of this study should be confirmed in a prospective study.

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“…Some retrospective studies [16][17][18][19] have attempted to answer this question unsuccessfully. Others, namely JCOG 0802 and CALGB 140503 -although not intended for this purpose -have provided relevant information that may guide clinical decisions.…”

Section: What To Choose? Segmentectomy or Wedge?mentioning

confidence: 99%

Lobar or sublobar resection of peripheral stage I non-small cell lung cancer

Lima,

Glorion,

Liberman

2024

Current Opinion in Pulmonary Medicine

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Purpose of review We aim to highlight two recent clinical trials that have altered the approach of the management of stage I nonsmall cell lung cancer. Recent findings The JCOG 0802 and CALGB 140503 trials demonstrated that sublobar resection is noninferior to lobectomy for overall and disease-free survival in patients with stage I nonsmall cell lung cancer. Summary Since 1962, lobectomy has been deemed the gold standard treatment for operable lung cancer. However, two recent clinical trials have demonstrated that, for select patients, sublobar resection is oncologically noninferior; results, which are leading us into a new era for the surgical management of lung cancer. Notwithstanding the progress made by these studies and the opportunities that have been put forth, questions remain. This review aims at reviewing the results of both trials and to discuss future perspectives for the surgical treatment of lung cancer.

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Thoracoscopic Wedge Resection Versus Segmentectomy for cT1N0 Lung Adenocarcinoma

Cited by 19 publications

References 33 publications

Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer

Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer

Treatment strategies for stage IA non-small cell lung cancer: A SEER-based population study

Lobar or sublobar resection of peripheral stage I non-small cell lung cancer

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