Elsevier

Journal of Thoracic Oncology

Volume 6, Issue 9, September 2011, Pages 1537-1541
Journal of Thoracic Oncology

Original Articles
Does Anatomical Segmentectomy Allow an Adequate Lymph Node Staging for cT1a Non-small Cell Lung Cancer?

https://doi.org/10.1097/JTO.0b013e3182209063Get rights and content
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Introduction

Anatomical segmentectomy is again under evaluation for the cure of T1a N0 non-small cell lung cancer and carcinoid tumors. Whether anatomical segmentectomy does permit or not, an adequate resection of nodal stations for staging or cure is still pending.

Methods

A case-matched study was ruled on patients with peripheral cT1a N0 M0 tumors that underwent anatomical segmentectomy or lobectomy. Dissection of lymph node stations 4, 5, 6, and 7 was identical in anatomical segmentectomy and lobectomy; stations 10, 11, 12, and 13 were also dissected carefully during anatomical segmentectomy.

Results

We individually matched 46 (69% men) anatomical segmentectomy with 46 (71% men) lobectomy for age, anatomical segment, and size of the tumor. The median (interquartile range) size of the resected lesions was 1.7 cm (1.35–1.95 cm) in anatomical segmentectomy and 1.6 cm (1.3–1.9 cm) (p = 0.96) in lobectomy. The anatomical segmentectomy and lobectomy resection margins were free of cancer. The median number (interquartile range) of total dissected lymph nodes was 12 (8–5–14) in anatomical segmentectomy compared with 13 (12–14.5) in lobectomy (p = 0.68), with a number of N1 nodes being 6 (4–7.5) and 7 (4.5–9.5) (p = 0.43), respectively, and N2 nodes 5.5 (4–7.7) and 5 (4–6.5) (p = 0.88). Only 1 patient of 46 (2%) anatomical segmentectomy was N1, whereas in lobectomy, 4% had N1 (2 patients). Freedom from recurrence at 36 months was 100% for anatomical segmentectomy and 93.5% for lobectomy (p = 0.33).

Conclusions

Anatomical segmentectomy for cT1a tumors compared with lobectomy procures an adequate number of N1 and N2 nodes for pathological examination. Cancer-specific survival was equivalent at 36 months.

Key Words

Non-small cell lung cancer
Sublobar lung resections
Lung segmentectomy
Lymph node staging

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Disclosure: The authors declare no conflicts of interest.