Segmentectomy versus Lobectomy for Non-small Cell Lung Cancer: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGZhen-rong ,  LIUDe-ruo , GUOYong-qing , SHIBin , TIANYan-chu , SONGZhi-yi , LIANGChao-yang , FENGHong-xiang

Department of Thoracic Surgery, Beijing China-Japan Friendship Hospital, Beijing 100029, P. R. China;

Corresponding author：

LIUDe-ruo, Email: deruoliu@vip.sina.com

Keywords：

Segmentectomy; Lobectomy; Lung cancer; Pulmonary benign disease

DOI：

10.7507/1007-4848.20150189

Video：

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Objective To evaluate the safety and efficacy of segmentectomy for early stage non-small cell lung cancer. Methods We retrospectively analyzed the clinical data of 88 patients with pulmonary malignant or benign lung tumor who underwent segmentectomy in our hospital between January 2007 and December 2012. There were 45 male and 43 female patients. There were 29 patients in the segmentectomy group and 59 patients in the lobectomy group. Nonsmall cell lung cancer patients underwent segmentectomy were matched with non-small cell lung cancer patients who underwent lobectomy. Perioperative factors and tumor relative prognosis were analyzed. Results Segmentectomy were performed in 29 patients in our institution. Average operation time was 210 minutes. Intraoperative blood loss was 166 ml. Postoperative drainage was 2 147 ml. The average extubation duration was 6 days. No significant difference was found in operation time (P>0.999), intraoperative blood loss (P=0.207), postoperative drainage (P=0.946), extubation duration (P=0.804), and postoperative complication (P>0.999) between segmentectomy pulmonary benign disease and segmentectomy lung cancer groups. Compared with lobectomy, segmentectomy showed similar operation time (P=0.462), intraoperative blood loss (P=0.783), extubation duration (P=0.072), complication ratio (P>0.999), and postoperative recurrence/metastasis ratio (P=0.417). While the number of N1 lymph nodes (P=0.033) and N1 station (P=0.024) were fewer in the segmentectomy group than those in the lobectomy group. The overall survival rate (P=0.340) and disease free survival rate (P=0.373) were both comparable between the segmentectomy and the lobectomy group. Conclusion Segmentectomy could be an alternate of lobectomy for patients with selective pulmonary benign disease, and for some early stage non-small cell lung cancer patients with restricted pulmonary function.

Citation： ZHANGZhen-rong, LIUDe-ruo, GUOYong-qing, SHIBin, TIANYan-chu, SONGZhi-yi, LIANGChao-yang, FENGHong-xiang. Segmentectomy versus Lobectomy for Non-small Cell Lung Cancer: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(8): 754-759. doi: 10.7507/1007-4848.20150189 Copy

1.	Churchill ED, Belsey R. Segmental pneumonectomy in bronchiectasis:The lingula segment of the left upper lobe. Ann Surg, 1939, 109:481-499.
2.	Jensik RJ, Faber LP, Milloy FJ, et al. Segmental resection for lung Cancer. a fifteen-year experience. J Thorac Cardiovasc Surg, 1973, 66:563-572.
3.	Nakamura H, Taniguchi Y, Miwa K, et al. Comparison of the surgical outcomes of thoracoscopic lobectomy, segmentectomy, and wedge resection for clinical stageⅠnon-small cell lung cancer. Thorac Cardiov Surg, 2011, 59:137-141.
4.	张小龙, 刘伦旭. 电视胸腔镜肺段切除术治疗早期非小细胞肺癌的研究进展. 中国胸心血管外科临床杂志, 2012, 19(2):177-180.
5.	Yamashita S, Tokuishi K, Anami K, et al. Thoracoscopic segmentectomy for T1 classification of non-small cell lung cancer:a single center experience. Eur J Cardiothorac Surg, 2012, 42:83-88.
6.	Pettiford BL, Schuchert MJ, Santos R, et al. Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer. Thorac Surg Clin, 2007, 17:175-190.
7.	Ginsberg RH, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60:615-623.
8.	Li zX, Yang H, She KL, et al. The role of segmental nodes in the pathological staging of non-small cell lung cancer. J Cardiothorac Surg, 2013, 8:225.
9.	Nomori H, Mori T, Izumi Y, et al. Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 nonsmall cell lung cancer? J Thorac Cardiovasc Surg, 2012,143:820-824.
10.	Okada M, Sakamoto T, Nishio W, et al. Characteristics and prognosis of patients after resection of non-small cell lung carcinoma measuring 2 cm or less in greatest dimension. Cancer, 2003, 988:535-541.
11.	Martini N, Bains MS, Burt ME, et al. Incidence of local recurrence and second primary tumors in resected stage Ⅰ lung cancer. J Thorac Cardiovasc Surg, 1995, 109:120-129.
12.	Landreneau RJ, Sugarbaker DJ, Mack MJ, et al. Wedge resection versus lobectomy for stage Ⅰ (T1 N0 M0) non-small-cell lung cancer. J Thorac Cardiovasc Surg, 1997, 113:691-700.
13.	zhao X, Qian L, Luo Q, et al. Segmentectomy as a safe and equally effective surgical option under complete video-assisted thoracic surgery for patients of stage Ⅰ non-small cell lung cancer. J Cardiothorac Surg, 2013, 29(8):116.
14.	Bonfils-Roberts EA, Clagett OT. Contemporary indications for pulmonary segmental resections. J Thorac Cardiovasc Surg, 1972, 63:433-438.
15.	Shapiro M, Weiser TS, Wisnivesky JP, et al. Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stageⅠ lung cancer. J Thorac Cardiovasc Surg, 2009, 137:1388-1393.
16.	Swanson JS. Segmentectomy for lung cancer. Semin Thorac Surg, 2010, 22:244-249.

1. Churchill ED, Belsey R. Segmental pneumonectomy in bronchiectasis:The lingula segment of the left upper lobe. Ann Surg, 1939, 109:481-499.
2. Jensik RJ, Faber LP, Milloy FJ, et al. Segmental resection for lung Cancer. a fifteen-year experience. J Thorac Cardiovasc Surg, 1973, 66:563-572.
3. Nakamura H, Taniguchi Y, Miwa K, et al. Comparison of the surgical outcomes of thoracoscopic lobectomy, segmentectomy, and wedge resection for clinical stageⅠnon-small cell lung cancer. Thorac Cardiov Surg, 2011, 59:137-141.
4. 张小龙, 刘伦旭. 电视胸腔镜肺段切除术治疗早期非小细胞肺癌的研究进展. 中国胸心血管外科临床杂志, 2012, 19(2):177-180.
5. Yamashita S, Tokuishi K, Anami K, et al. Thoracoscopic segmentectomy for T1 classification of non-small cell lung cancer:a single center experience. Eur J Cardiothorac Surg, 2012, 42:83-88.
6. Pettiford BL, Schuchert MJ, Santos R, et al. Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer. Thorac Surg Clin, 2007, 17:175-190.
7. Ginsberg RH, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60:615-623.
8. Li zX, Yang H, She KL, et al. The role of segmental nodes in the pathological staging of non-small cell lung cancer. J Cardiothorac Surg, 2013, 8:225.
9. Nomori H, Mori T, Izumi Y, et al. Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 nonsmall cell lung cancer? J Thorac Cardiovasc Surg, 2012,143:820-824.
10. Okada M, Sakamoto T, Nishio W, et al. Characteristics and prognosis of patients after resection of non-small cell lung carcinoma measuring 2 cm or less in greatest dimension. Cancer, 2003, 988:535-541.
11. Martini N, Bains MS, Burt ME, et al. Incidence of local recurrence and second primary tumors in resected stage Ⅰ lung cancer. J Thorac Cardiovasc Surg, 1995, 109:120-129.
12. Landreneau RJ, Sugarbaker DJ, Mack MJ, et al. Wedge resection versus lobectomy for stage Ⅰ (T1 N0 M0) non-small-cell lung cancer. J Thorac Cardiovasc Surg, 1997, 113:691-700.
13. zhao X, Qian L, Luo Q, et al. Segmentectomy as a safe and equally effective surgical option under complete video-assisted thoracic surgery for patients of stage Ⅰ non-small cell lung cancer. J Cardiothorac Surg, 2013, 29(8):116.
14. Bonfils-Roberts EA, Clagett OT. Contemporary indications for pulmonary segmental resections. J Thorac Cardiovasc Surg, 1972, 63:433-438.
15. Shapiro M, Weiser TS, Wisnivesky JP, et al. Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stageⅠ lung cancer. J Thorac Cardiovasc Surg, 2009, 137:1388-1393.
16. Swanson JS. Segmentectomy for lung cancer. Semin Thorac Surg, 2010, 22:244-249.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Segmentectomy versus Lobectomy for Non-small Cell Lung Cancer: A Case Control Study

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