Affiliation:
1. Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital Capital Medical University Beijing China
2. Department of Pulmonary Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences Hangzhou China
Abstract
AbstractBackgroundSublobar resection (wedge resection and segmentectomy) has been established as an oncologically equivalent option to lobectomy for early‐stage patients with non‐small cell lung cancer (NSCLC) ≤ 2 cm. However, the optimal approach of sublobar resection remains subject to debate. In the present study we aimed to compare the oncological outcomes of wedge resection and segmentectomy in these patients.MethodsWe identified patients with pT1a‐bN0M0 NSCLC who underwent wedge resection and segmentectomy from the Surveillance, Epidemiology, and End Results database between 2010 and 2020. A Cox regression model and propensity‐score matching (PSM) analysis were used. Overall survival (OS) and lung cancer‐specific survival (LCSS) were compared using the Kaplan–Meier method.ResultsA total of 4190 patients met our selection criteria, including wedge resection in 3137 and segmentectomy in 1053. Patients undergoing wedge resection were less likely to have total lymph nodes resected (4 vs. 7, p < 0.001). Before PSM, patients undergoing segmentectomy had a higher 5‐year OS rate (87.75% vs. 82.72%; p = 0.0023), while exhibiting a similar LCSS rate (93.45% vs. 92.73%; p = 0.32). After PSM, segmentectomy consistently demonstrated significantly better OS and there was no statistically significant difference in LCSS. Analysis of causes of death revealed that a higher incidence of deaths related to other causes among patients undergoing wedge resection compared to those undergoing segmentectomy.ConclusionsBoth wedge resection and segmentectomy yield comparable oncological outcomes for patients with NSCLC ≤ 2 cm, although segmentectomy exhibits superior OS due to less death related to other causes.