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- Title
Segmentectomy versus lobectomy for solid predominant cN0 lung cancer: analysis using visual evaluation of positron emission tomography.
- Authors
Kagimoto, Atsushi; Tsutani, Yasuhiro; Mimae, Takahiro; Miyata, Yoshihiro; Okada, Morihito
- Abstract
Open in new tab Download slide Open in new tab Download slide OBJECTIVES Prognosis after segmentectomy for early-stage non-small cell lung cancer (NSCLC) with a high consolidation tumour ratio (CTR) and [18F]-fluoro-2-deoxy- d -glucose (FDG) accumulation on positron emission tomography/computed tomography is unclear. METHODS Participants of this study were 465 patients who underwent lobectomy or segmentectomy for clinical N0 NSCLC presenting solid component predominant tumour (CTR >50%) with a whole size ≤3 cm. Accumulations of FDG on positron emission tomography/computed tomography scans were scored according to the Deauville criteria, a 5-point visual evaluating method (Deauville score). The correlations between Deauville score, prognosis, and procedures were analysed. RESULTS Characteristics of pathological invasiveness, such as lymphatic invasion (P < 0.001), vascular invasion (P < 0.001) and pleural invasion (P < 0.001), and non-adenocarcinoma histologies (P < 0.001) were more common in patients with Deauville scores of 3–5. The cumulative incidence of recurrence (CIR) was higher in patients with Deauville scores of 3–5 (P < 0.001). The CIR after lobectomy and segmentectomy did not differ significantly among patients with Deauville scores of 1 or 2 (P = 0.598) or those with Deauville scores of 3–5 (P = 0.322). In the analysis of propensity score matched cohort, the CIR after lobectomy and segmentectomy did not differ significantly between patients with Deauville scores of 1 or 2 and Deauville scores of 3–5. CONCLUSIONS Segmentectomy may be feasible for NSCLC with high CTR (>50%) and accumulation of FDG. This finding should be confirmed in larger prospective studies.
- Subjects
POSITRON emission tomography; LUNG cancer; NON-small-cell lung carcinoma; LOBECTOMY (Lung surgery); COMPUTED tomography; TEMPORAL lobectomy; PROPENSITY score matching
- Publication
European Journal of Cardio-Thoracic Surgery, 2022, Vol 61, Issue 2, p279
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezab434