Journal
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
Volume 32, Issue 4, Pages 546-551Publisher
OXFORD UNIV PRESS
DOI: 10.1093/icvts/ivaa298
Keywords
Lung cancer; Lobectomy; Segmentectomy; European Society of Thoracic Surgeons database; Sublobar resection; Video-assisted thoracic surgery
Ask authors/readers for more resources
According to the ESTS database, segmentectomy is preferred for 'compromised' patients with limited respiratory function, higher ASA score, and relevant comorbidities, despite a lower rate of postoperative complications, the efficacy is similar to lobectomy.
OBJECTIVES : The aims of this study were to describe the potential selection criteria for patients scheduled for lobectomy versus segmentectomy for stage I non-small-cell lung cancer and to compare the 2 procedures in terms of intraoperative variables and postoperative outcomes using the European Society of Thoracic Surgeons (ESTS) Registry. METHODS: This observational multicentre retrospective cross-sectional study was based on data collected from the ESTS database. The following were set as inclusion criteria: pulmonary lobectomy or segmentectomy for stage I primary lung cancer (according to 8th TNM edition), no previous lung surgery and no induction chemotherapy or radiotherapy. Statistical significance was examined using Mann-Whitney or 2 proportions Z tests. RESULTS: Among 63 542 patients enrolled in the ESTS database (2007-2018), 17 692 met the inclusion criteria: 15 845 patients received lobectomy and 1847 segmentectomy. Video-assisted thoracic surgery (VATS) lobectomy and VATS segmentectomy were the 27.8% and 31.9% of the procedures, respectively. Lobectomy group was significantly younger and had a lower American Society of Anaesthesiology (ASA) score, lower comorbidities prevalence and better respiratory function. The segmentectomy group had lower complications rate (25.6% vs 33.8%). When considering only the last 5 years, ASA score was similar between the 2 groups, although pulmonary function remained significantly lower in the segmentectomy group. CONCLUSIONS: According to the ESTS database, segmentectomy was preferably offered to 'compromised' patients, with limited respiratory function, higher ASA score and relevant comorbidities. Nevertheless, the procedure showed lower complications rate and similar short-term outcomes compared to lobectomy. During the last 5 years, segmentectomy appeared to be regarded as a valid alternative, even for selected patients who could tolerate both procedures.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available