Is it Unjustified to Perform Segmentectomy in Surgical Treatment of Lung Adenocarcinoma?

Arch Iran Med. 2021 Jun 1;24(6):487-495. doi: 10.34172/aim.2021.70.

Abstract

Background: The aim of our study differs from similar studies since we compared superiority and similarity of segmentectomy performed for early-stage lung cancer over lobectomy in terms of clinical and oncological results.

Methods: The data from 294 patients who underwent anatomical resection due to primary lung cancer were retrospectively reviewed. Data from 99 patients who underwent lobectomy and segmentectomy due to early-stage lung adenocarcinoma were analyzed. Patients were divided into two groups: 84 patients undergoing lobectomy and 15 patients undergoing segmentectomy. Both groups were analyzed in terms of epidemiological, surgical and oncological results, by comparing several parameters.

Results: The most common postoperative complication was observed in the respiratory system. In total, 25 complication (29.8%) in the lobectomy group and 3 complications (20%) in the segmentectomy group were observed related to the postoperative respiratory system (P = 0.546). There was no statistically significant difference between the two groups in terms of recurrence-metastasis during follow-up, chemotherapy-radiotherapy condition and mortality. Main discharge time and thorax drain termination time were shorter in the segmentectomy group (P = 0.011 and P = 0.033, respectively). There was no statistically significant difference between the two groups in terms of postoperative survival or disease-free time (P = 0.361 and P = 0.461, respectively).

Conclusion: If there is no contraindication, segmentectomy can be considered as the surgical treatment for lung adenocarcinomas with tumor size of 2 cm or less and a minimum 1 cm clean surgical margin.

Keywords: Adenocarcinoma; Lobectomy; Segmentectomy.

MeSH terms

  • Adenocarcinoma of Lung* / surgery
  • Humans
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Neoplasm Staging
  • Pneumonectomy
  • Retrospective Studies
  • Treatment Outcome