Interpretation of Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Junhao , LIU Chengwu ,  LIU lunxu

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

LIU lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Non-small cell lung cancer; segmentectomy; expert consensus; Delphi study

DOI：

10.7507/1007-4848.202309016

Video：

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As the incidence of lung cancer continues to rise, segmentectomy has emerged as a favored surgical technique for treating selective early-stage non-small cell lung cancer patients, gaining increasing support from thoracic surgery specialists. However, there remains a deficiency in clinical guidance concerning indications and other related aspects for segmentectomy. In April 2023, a collaborative effort among 15 Asia thoracic surgery experts led to the publication of the "Asian expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study". This study presents a total of 36 expert consensus agreements across three aspects: patient indications, surgical approaches, lymph node assessment, outlining key principles of them. This paper intends to provide a brief interpretation of these consensuses for the reference of colleagues in clinical practice.

Citation： WU Junhao, LIU Chengwu, LIU lunxu. Interpretation of Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(12): 1669-1673. doi: 10.7507/1007-4848.202309016 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Kim AW, Detterbeck FC, Boffa DJ, et al. Characteristics associated with the use of nonanatomic resections among medicare patients undergoing resections of early-stage lung cancer. Ann Thorac Surg, 2012, 94(3): 895-901.
3.	Nakamura H, Kazuyuki S, Kawasaki N, et al. History of limited resection for non-small cell lung cancer. Ann Thorac Cardiovasc Surg, 2005, 11(6): 356-362.
4.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. The Lancet, 2022, 399(10335): 1607-1617.
5.	Altorki NK, Wang X, Wigle D, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: Post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med, 2018, 6(12): 915-924.
6.	Sato M, Murayama T, Nankajima J. Concepts and techniques: How to determine and identify the appropriate target segment in anatomical pulmonary segmentectomy? J ThoracDis, 2019, 11(3): 972-986.
7.	Liu L, Aokage K, Chen C, et al. Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study. JTCVS Open, 2023, 14: 483-501.
8.	Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
9.	Bai W, Li S. Prognosis of segmentectomy in the treatment of stage ⅠA non-small cell lung cancer. Oncol Lett, 2021, 21(1): 74.
10.	Handa Y, Tsutani Y, Mimae T, et al. Surgical outcomes of complex versus simple segmentectomy for stage Ⅰ non-small cell lung cancer. Ann Thorac Surg, 2019, 107(4): 1032-1039.
11.	Nex G, Scjiavone M, De Palmaa A, et al. How to identify intersegmental planes in performing sublobar anatomical resections. J Thorac Dis, 2020, 12(6): 3369-3375.
12.	Lu T, Zang R, Jiang K, et al. Electrocautery vs. stapler in comparing safety for segmentectomy of lung cancer: A meta-analysis. Front Surg, 2021, 8: 711685.
13.	Wei S, Guo C, He J, et al. Effect of vein-first vs. artery-first surgical technique on circulating tumor cells and survival in patients with non-small cell lung cancer: A randomized clinical trial and registry-based propensity score matching analysis. JAMA Surg, 2019, 154(7): e190972.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Kim AW, Detterbeck FC, Boffa DJ, et al. Characteristics associated with the use of nonanatomic resections among medicare patients undergoing resections of early-stage lung cancer. Ann Thorac Surg, 2012, 94(3): 895-901.
3. Nakamura H, Kazuyuki S, Kawasaki N, et al. History of limited resection for non-small cell lung cancer. Ann Thorac Cardiovasc Surg, 2005, 11(6): 356-362.
4. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. The Lancet, 2022, 399(10335): 1607-1617.
5. Altorki NK, Wang X, Wigle D, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: Post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med, 2018, 6(12): 915-924.
6. Sato M, Murayama T, Nankajima J. Concepts and techniques: How to determine and identify the appropriate target segment in anatomical pulmonary segmentectomy? J ThoracDis, 2019, 11(3): 972-986.
7. Liu L, Aokage K, Chen C, et al. Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study. JTCVS Open, 2023, 14: 483-501.
8. Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
9. Bai W, Li S. Prognosis of segmentectomy in the treatment of stage ⅠA non-small cell lung cancer. Oncol Lett, 2021, 21(1): 74.
10. Handa Y, Tsutani Y, Mimae T, et al. Surgical outcomes of complex versus simple segmentectomy for stage Ⅰ non-small cell lung cancer. Ann Thorac Surg, 2019, 107(4): 1032-1039.
11. Nex G, Scjiavone M, De Palmaa A, et al. How to identify intersegmental planes in performing sublobar anatomical resections. J Thorac Dis, 2020, 12(6): 3369-3375.
12. Lu T, Zang R, Jiang K, et al. Electrocautery vs. stapler in comparing safety for segmentectomy of lung cancer: A meta-analysis. Front Surg, 2021, 8: 711685.
13. Wei S, Guo C, He J, et al. Effect of vein-first vs. artery-first surgical technique on circulating tumor cells and survival in patients with non-small cell lung cancer: A randomized clinical trial and registry-based propensity score matching analysis. JAMA Surg, 2019, 154(7): e190972.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Interpretation of Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study

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