Subsegmentectomy Versus Segmentectomy Resection for the Treatment of Operable Patients with Stage IA Non-small Cell Lung Cancer: A Meta-analysis

Overview

Journal Front Surg

Specialty General Surgery

Date 2023 Jan 23

PMID 36684370

Authors

Liwei Song

Shuping Li

Xuefeng Hao

Renjing Jin

Wei Li

Minghang Zhang

Jinghui Wang

Shijie Zhou

Teng Ma

Shaofa Xu

Affiliations

Soon will be listed here.

Abstract

Background: There were new points of interest in performing subsegmentectomy and segmentectomy for patients with early stage non-small cell lung cancer (NSCLC). However, whether patients who underwent subsegmentectomy could obtain satisfactory clinical outcomes remains unclear. The present study aimed to compare the clinical outcomes and security of surgical procedures between subsegmentectomy and segmentectomy.

Methods: A systematic review and meta-analysis was performed through five online databases to identify the included literatures which presented intact clinical outcome data among different surgical procedures. The included studies were evaluated based on precise and predefined inclusion criteria.

Results: There were 4 published studies identified in this meta-analysis. A total of 325 patients who underwent subsegmentectomy and 904 patients who underwent segmentectomy were involved in this analysis. The duration of drainage [MD -0.19; 95%CI (-0.36, -0.02), = 0.03] and postoperative hospital stay [MD -0.30; 95%CI (-0.58, -0.02), = 0.009] of subsegmentectomy were significantly less than that of segmentectomy. There was no statistically significant difference among recurrence rate [OR 0.85; 95%CI (0.21, 3.42), = 0.82], operation time, blood loss, incidence of complications [OR 0.83; 95%CI (0.58, 1.20), = 0.33] between subsegmentectomy and segmentectomy in patients with stage IA NSCLC.

Conclusion: The meta-analysis was firstly performed to compare perioperative outcomes among surgical procedures. The perioperative outcomes were comparable between subsegmentectomy and segmentectomy. Subsegmentectomy might be an alternative treatment for the deep tumor with size less than 1.5 cm and mainly composed of Ground Glass Opacity (GGO).

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References

Yoshimoto K, Nomori H, Mori T, Ohba Y, Shiraishi K, Ikeda K . Combined subsegmentectomy: postoperative pulmonary function compared to multiple segmental resection. J Cardiothorac Surg. 2011; 6:17. PMC: 3050688. DOI: 10.1186/1749-8090-6-17. View

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

El-Sherif A, Fernando H, Santos R, Pettiford B, Luketich J, Close J . Margin and local recurrence after sublobar resection of non-small cell lung cancer. Ann Surg Oncol. 2007; 14(8):2400-5. DOI: 10.1245/s10434-007-9421-9. View

Li J, Wang Y, Li J, Cao S, Che G . Meta-analysis of Lobectomy and Sublobar Resection for Stage I Non-small Cell Lung Cancer With Spread Through Air Spaces. Clin Lung Cancer. 2021; 23(3):208-213. DOI: 10.1016/j.cllc.2021.10.004. View

Kato H, Oizumi H, Inoue T, Oba E, Nakamura K, Hayashi J . Port-access thoracoscopic anatomical lung subsegmentectomy. Interact Cardiovasc Thorac Surg. 2013; 16(6):824-9. PMC: 3653462. DOI: 10.1093/icvts/ivt037. View

Moon M, Moon Y, Moon S . Segmentectomy versus lobectomy in early non-small cell lung cancer of 2 cm or less in size: A population-based study. Respirology. 2018; 23(7):695-703. DOI: 10.1111/resp.13277. View

Howington J, Blum M, Chang A, Balekian A, Murthy S . Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl):e278S-e313S. DOI: 10.1378/chest.12-2359. View

Mohiuddin K, Haneuse S, Sofer T, Gill R, Jaklitsch M, Colson Y . Relationship between margin distance and local recurrence among patients undergoing wedge resection for small (≤2 cm) non-small cell lung cancer. J Thorac Cardiovasc Surg. 2014; 147(4):1169-75. DOI: 10.1016/j.jtcvs.2013.11.056. View

Kato H, Oizumi H, Suzuki J, Hamada A, Watarai H, Nakahashi K . Video-assisted thoracoscopic subsegmentectomy for small-sized pulmonary nodules. J Vis Surg. 2018; 3:105. PMC: 5677508. DOI: 10.21037/jovs.2017.06.05. View

10.

Jian Z, Li C, Feng X, Yin Z, Han Y, Zhang Y . Robotic versus thoracoscopic combined anatomic subsegmentectomy for early-stage lung cancer: early results of a cohort study. J Thorac Dis. 2022; 14(5):1441-1449. PMC: 9186238. DOI: 10.21037/jtd-21-1895. View

11.

Nakamoto K, Omori K, Nezu K . Superselective segmentectomy for deep and small pulmonary nodules under the guidance of three-dimensional reconstructed computed tomographic angiography. Ann Thorac Surg. 2010; 89(3):877-83. DOI: 10.1016/j.athoracsur.2009.11.037. View

12.

Kanzaki M, Maeda H, Wachi N, Kikkawa T, Komine H, Isaka T . Complete video-assisted thoracoscopic multi-subsegmentectomy based on patients' specific virtual 3-D pulmonary models. Asian J Endosc Surg. 2013; 6(2):110-5. DOI: 10.1111/ases.12015. View

13.

Ma Q, Wang F, Wang A, Pang L, Jiang R . Thoracoscopic Anatomic Left Lower Lobe S6b Subsegmentectomy. Ann Thorac Surg. 2022; 114(4):e291-e294. DOI: 10.1016/j.athoracsur.2021.12.034. View

14.

Koike T, Koike T, Yoshiya K, Tsuchida M, Toyabe S . Risk factor analysis of locoregional recurrence after sublobar resection in patients with clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2013; 146(2):372-8. DOI: 10.1016/j.jtcvs.2013.02.057. View

15.

Kato H, Oizumi H, Suzuki J, Suzuki K, Takamori S . Roles and outcomes of thoracoscopic anatomic lung subsegmentectomy for lung cancer. Interact Cardiovasc Thorac Surg. 2022; 34(1):81-90. PMC: 8932510. DOI: 10.1093/icvts/ivab221. View

16.

Landreneau R, Normolle D, Christie N, Awais O, Wizorek J, Abbas G . Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage I non-small-cell lung cancer: a propensity-matched analysis. J Clin Oncol. 2014; 32(23):2449-55. PMC: 4121502. DOI: 10.1200/JCO.2013.50.8762. View

17.

Huang C, Hsu P, Chen C, Yeh Y, Hsu H, Shih C . Surgeons' preference sublobar resection for stage I NSCLC less than 3 cm. Thorac Cancer. 2020; 11(4):907-917. PMC: 7113050. DOI: 10.1111/1759-7714.13336. View

18.

Kates M, Swanson S, Wisnivesky J . Survival following lobectomy and limited resection for the treatment of stage I non-small cell lung cancer<=1 cm in size: a review of SEER data. Chest. 2010; 139(3):491-496. DOI: 10.1378/chest.09-2547. View

19.

Altorki N, Wang X, Wigle D, Gu L, Darling G, Ashrafi A . 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. PMC: 6396275. DOI: 10.1016/S2213-2600(18)30411-9. View

20.

Chang C, Yen Y, Lin C, Chen Y, Huang W, Tseng Y . Single-port video-assisted thoracoscopic surgery subsegmentectomy: The learning curve and initial outcome. Asian J Surg. 2019; 43(5):625-632. DOI: 10.1016/j.asjsur.2019.09.009. View