Library of the School of Health Sciences
ΠΜΣ Ογκολογία Θώρακα: Σύγχρονη Κλινικο-Εργαστηριακή Προσέγγιση και Έρευνα

2024-03-12

2024

Kyritsis Ioannis

Περικλής Τόμος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ανδριανή Χαρπίδου, Επιστημονική Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ
Γρηγόριος Στρατάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Η κλινική σημασία της λοβεκτομής έναντι της τμηματεκτομής σε στάδιο Ι ΜΜΚΠ

Greek

The importance of lobectomy versus segmentectomy in stage I NSCLC

Lung cancer remains the leading cause of death among oncological patients worldwide. Surgical resection offers the best prognosis for patients with early-stage non-small cell lung cancer (NSCLC). Lobectomy with lymph node dissection is traditionally the gold standard in resectable NCSLC. The continuous increase in the aging of the population results in more patients with NSCLC who are older and more fragile. On the other side, medical technology contributes in early detection of small lung tumors. Under the light of these new data, many scientists question the role of lobectomy, in favor of sublobar resection, as anatomical segmentectomy, for parenchyma preservation.
Recent randomised control trials examined the non-inferiority of segmentectomy compared to lobectomy for Stage I NSCLC. A study from Japan (JCOG0802/WJOG4607L) included more than 1000 such patients. The inclusion criteria referred to peripheral carcinoma 2 cm in diameter with a consolidation tumor (C/T) ratio >0,5 and negative hilar nodes. The 5-year overall survival was 94.3% for segmentectomy and 91.1% for lobectomy (p<0.0001). However, the proportions of patients with local relapse were 10.5% for segmentectomy and 5.4% for lobectomy (p<0.0018). Thus, this was the first phase 3 trial to prove the benefits of segmentectomy versus lobectomy in overall survival of patients with peripheral NSCLC 2 cm.
We had the opportunity to analyze the results of 40 patients with Stage I NSCLC who were operated at the <> University Hospital. Thirteen patients underwent anatomical segmentectomy and 27 lobectomy. The 5-year overall survival reached 84% after segmentectomy and 74% after lobectomy. However, the risk of local relapse was 2.3 times higher for segmentectomy compared to lobectomy. Our results agree with those of the Japanese study, although there were patients with tumors >2cm in the segmentectomy group. In conclusion, segmentectomy gains ground under circumstances and lobectomy remains the gold standard in stage I NSCLC.

Health Sciences

Lobectomy, Segmentectomy, Non small cell lung cancer, Survival, Relapse

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File access is restricted until 2024-09-13.

https://pergamos.lib.uoa.gr/uoa/dl/object/3391247