J Cancer 2021; 12(6):1708-1714. doi:10.7150/jca.49683

Research Paper

Segmentectomy or Wedge Resection in Stage IA Lung Squamous Cell Carcinoma and Adenocarcinoma?

Guoshu Li1#, Shuanshuan Xie1#, Feng Hu2#, Min Tan1, Lihong Fan1✉, Changhui Wang1✉

1. Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
2. Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai 200336, China.
#These authors have contributed equally to this work.

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Citation:
Li G, Xie S, Hu F, Tan M, Fan L, Wang C. Segmentectomy or Wedge Resection in Stage IA Lung Squamous Cell Carcinoma and Adenocarcinoma?. J Cancer 2021; 12(6):1708-1714. doi:10.7150/jca.49683. Available from https://www.jcancer.org/v12p1708.htm

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Abstract

Objectives: We performed this study to compare survival outcomes of segmentectomy (SG) and wedge resection (WR) in stage IA lung squamous cell carcinoma (SQCC) and lung adenocarcinoma (AD).

Methods: Using the Surveillance, Epidemiology, and End Results registry (SEER), we identified 1529 and 4070 patients with stage IA SQCC and AD, respectively, who had complete clinical information between 2004 and 2015. We used Kaplan-Meier analysis to determine the propensity score for patients with limited resection based on the preoperative characteristics of patients. Lung cancer-specific survival (LCSS) was compared in patients treated with WR and SG after adjusting, stratifying, or matching lung cancer patients according to propensity score.

Results: Kaplan-Meier analysis demonstrated that there was a statistically significant difference in survival curves (log rank P=0.01) for patients with stage IA SQCC between SG and WR. But there was no statistically significant difference in survival curves (log rank P>0.05) in patients with stage IA AD between the two limited resections. Compared with the WR, The hazard ratios (95% confidence intervals) of SG were 0.689 (0.519-0.914) and 0.896 (0.752-1.067) in patients with stage IA SQCC and AD, respectively.

Conclusion: This study suggests that SG can yield superior survival outcome compared with WR in patients with stage IA SQCC. However, the survival outcomes of SG and WR are generally equivalent in patients with stage IA AD.

Keywords: SEER, segmentectomy, wedge resection, non-small cell lung cancer, survival