Prognosis of segmentectomy and lobectomy for radiologically aggressive small-sized lung cancer

Abstract

OBJECTIVES: The purpose of this study was to determine the radiological characteristics of aggressive small-sized lung cancer and to compare the outcomes between segmentectomy and lobectomy in patients with these lung cancers. METHODS: A series of 1046 patients with clinical stage IA1-IA2 lung cancer who underwent lobectomy or segmentectomy at 3 institutions was retrospectively evaluated to identify radiologically aggressive small-sized (solid tumour size _ 0.8) or highly metabolic (maximum standardized uptake >_ 2.5) tumour. Among patients with radiologically aggressive lung cancer, no significant statistical differences in 5-year recurrence-free (81% vs 90%; P = 0.33) and overall (88% vs 93%; P = 0.76) survival comparing lobectomy (n = 392) to segmentectomy (n = 130) were observed. Among 115 propensity-matched pairs, 5-year recurrence-free survival and overall survival were similar between patients who underwent lobectomy and those who underwent segmentectomy (83.3% and 88.3% vs 90.9% and 94.5%, respectively). CONCLUSIONS: Difference in survival was not identified with segmentectomy and lobectomy in patients with radiologically aggressive small-sized lung cancer with high risk of recurrence.