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| |  Anatomic Segmentectomy and Lobectomy Show Equivalent Recurrence, Survival in Patients With NSCLC: Presented at CHEST 2010 By Jim Kling VANCOUVER -- November 5, 2010 -- Anatomic segmentectomy has similar recurrence and survival rates to lobectomy in patients with stage I non-small-cell lung cancer (NSCLC), and also leads to reduced perioperative mortality, researchers said here at the 2010 Annual Meeting of the American College of Chest Physicians. Anatomic segmentectomy, also known as sublobar resection, is increasingly used for managing pathologic stage I NSCLC, but many studies of the technique have focused on pathologic stage of the disease. Surgical decision-making is made on the basis of clinical stage, so the researchers set out to study anatomic segmentectomy with respect to clinical stage. The study compared outcomes for all patients surgically treated for clinical stage I NSCLC between 2002 and 2009, including 130 patients undergoing wedge resection, 235 patients undergoing anatomic segmentectomy, and 728 patients undergoing lobectomy. The average age of patients was 67.9 years, and gender and histology were similar among the 3 groups. Tumours were an average size of 2.9 cm, and pathology upstaging was demonstrated in 244 (22.3%) patients. Average follow-up time was 30.5 months. Locoregional recurrence was higher in wedge resection patients than anatomic segmentectomy (14.6% vs 8.9%). Compared with lobectomy, anatomic segmentectomy was associated with reduced mortality (0.4% vs 1.8%), similar locoregional recurrence, and similar recurrence-free survival. Overall survival was the same among the 3 groups. Patients who were pathologically upstaged had similar survival rates regardless of the extent of surgical resection. “What we’ve found is that when you do a formal anatomic lung resection, you can achieve essentially equivalent recurrence and survival compared with lobectomy, and that is better than the other form of sublobar resection, which is the traditional wedge resection,” said Matthew Schuchert, MD, University of Pittsburgh, Pittsburgh, Pennsylvania, on November 1. Dr. Schuchert added that he believes anatomic segmentectomy is ideal for patients with cardiopulmonary risk factors, and that the results suggest that the technique could be generalised to include any patient with early stage NSCLC if the results hold true in prospective studies. [Presentation title: Anatomic Lung Resection for Clinical Stage I Non-Small Cell Lung Cancer (NSCLC): Equivalent Outcomes Following Anatomic Segmentectomy and Lobectomy. Abstract 10797]
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