CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg
DOI: 10.1055/s-0040-1722172
Original Thoracic

Video-Assisted Thoracoscopic Segmentectomy for Deep and Peripheral Small Lung Cancer

Satoshi Takamori
1  Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan
,
Hiroyuki Oizumi
1  Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan
,
Jun Suzuki
1  Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan
,
Katsuyuki Suzuki
1  Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan
,
Takanobu Kabasawa
2  Department of Pathological Diagnostics, Faculty of Medicine, Yamagata University, Yamagata, Japan
› Author Affiliations
Funding The research reported in this publication was not supported by any external funding or grant.

Abstract

Background We aimed to retrospectively compare the long-term prognosis and recurrence after segmentectomy between nonsmall cell lung cancer (NSCLC) patients with deep and peripheral lesions.

Methods Data were extracted for 85 lobectomy-tolerable NSCLC patients with tumors measuring ≤2 cm, who underwent video-assisted thoracoscopic segmentectomy with curative intent during January 2006 to December 2014. Tumor location was determined by the surgeon using thin-slice (1 mm) and three-dimensional computed tomography. Overall and recurrence-free survival was compared between patients with peripheral and deep lesions using univariate and multivariate Cox proportional hazard models. The indications for segmentectomy included NSCLC measuring ≤2 cm and consolidation/tumor ratio ≤20%, solid NSCLC ≤1 cm, and indeterminate nodule ≤1.5 cm.

Results No recurrence of peripheral and deep lesions was noted. The 5-year overall survival was 96.4% for all patients, and 100 and 95.3% for patients with deep and peripheral lesions, respectively. There was no significant difference between the overall survival rates associated with the deep and peripheral lesions (95% confidence interval [CI], 89.5–98.8, nonsignificant, 86.4–98.4, respectively; p = 0.189). In a multivariate analysis, the American Society of Anesthesiologists score (hazard ratio [HR], 13.30; 95% CI, 1.31–210.36; p = 0.028) and histology (HR, 0.03; 95% CI, 0.00–0.32; p = 0.037) were independent prognostic factors for overall survival; tumor location was not a prognostic factor.

Conclusions When video-assisted thoracoscopic segmentectomy with curative intent was performed with sufficient surgical margins, the location of small NSCLC did not affect recurrence risk and prognosis. Video-assisted thoracoscopic segmentectomy for small NSCLC is acceptable, regardless of the tumor location.

Clinical Registration Number

The study protocol was approved by the Ethics Committee of our university (#2020–130).




Publication History

Received: 29 September 2020

Accepted: 18 November 2020

Publication Date:
04 February 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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