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Roshini Claire Anthony, 3 days ago

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Segmentectomy on par with lobectomy for early NSCLC

23 Jun 2018

Segmentectomy and lobectomy confer similar overall survival (OS) and lung cancer-specific survival (LCSS) among patients with primary nonsmall cell lung cancer (NSCLC) of 20 mm without lymph node or distant metastasis, a recent study has shown.

Overall, 15,358 patients were analysed, of which 14,549 underwent lobectomies and 809 segmentectomies. The 5-year OS was 76 percent and 74.4 percent for the lobectomy group and segmentectomy group, respectively.

No significant differences in OS or LCSS were observed among patients who underwent lobectomy vs segmentectomy, as shown by the propensity-matched hazard ratio (HR) for OS (HR, 1.195; 95 percent CI, 0.993–1.439) and LCSS (HR, 1.124; 0.860–1.469). These results were also supported by the inverse propensity-weighted analysis.

Elderly patients were more likely to undergo segmentectomy vs lobectomy. In the subset of patients aged ≥75 years, those in the segmentectomy group showed comparable OS (HR, 1.17; 0.87–1.58; p=0.31) and LCSS (HR, 0.94; 0.59–1.51; p=0.81) as those in the lobectomy group.

A recent study has shown that lobectomy, segmentectomy and wedge resection are comparable surgical procedures for patients with early NSCLC. Lobectomy and segmentectomy perform better than wedge resection for tumours from 1.1–2.0 cm, while lobectomy remains the standard surgical procedure for tumours from 2.1–3.0 cm. For patients unfit for lobectomy, segmentectomy and wedge resection show similar survival rates. [Ann Thorac Surg 2018;105:1483-1491]

The investigators extracted data of patients with primary NSCLC of 20 mm who were diagnosed from 2000–2014 from the Surveillance, Epidemiology and End Results database. They performed a propensity score analysis between lobectomy and segmentectomy to compare the two surgical interventions.

“Standard surgical management for early stage lung cancer is lobectomy with mediastinal lymph node dissection,” the investigators noted.

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Most Read Articles
Roshini Claire Anthony, 3 days ago

Patients with mild hypertension who are at low risk for cardiovascular disease (CVD) do not appear to derive mortality or CVD benefit from antihypertensive treatments, raising questions on the need for treatment in this population, according to a recent study from England.

Pearl Toh, 6 days ago
A personalized computerized neurofeedback intervention for training attention and memory shows potential in cognitive training for healthy elderly men, who improved in cognitive performance after the training, although no significant improvements were seen in the overall study population.
4 days ago
The simple Atrial fibrillation (AF) Better Care (ABC) pathway holistically updates the integrated care for AF patients and helps reduce the risk of adverse outcomes such as all-cause mortality, stroke/major bleeding/cardiovascular death and hospitalization, according to a study.
Yesterday
Type 1 diabetes impairs cognitive functioning in children, and this effect is exacerbated by extreme glycaemic levels, according to a recent meta-analysis.