Dziedzic R, et al. – This study sought to assess the overall survival for different types of resection for Stage I non-small-cell lung cancer (NSCLC). Wedge resection seemed associated with significantly lower 3–year and 5–year survival rates compared to the other methods of resection. No significant difference was observed regarding 3–year or 5–year survival rates between lobectomy and segmentectomy. In the treatment of patients with Stage I NSCLC, segmentectomy, but not wedge resection, could be considered an alternative to lobectomy.

Methods

• A retrospective analysis of the results of the surgical treatment of Stage I NSCLC was performed.
• From 1 January 2007 to 31 December 2013, authors collected data from 6905 patients who underwent Stage I NSCLC operations in the Polish National Lung Cancer Registry (PNLCR) and assessed overall survival.
• They used a propensity score-matched analysis to compare 3 groups of patients, each consisting of 231 patients who underwent lobectomy, segmentectomy, or wedge resection.

Results

• In the unmatched and matched patient groups, lobectomy and segmentectomy seemed associated with a marked benefit compared to wedge resection in terms of overall survival (log-rank P < 0.001 and P = 0.001).
• In this study, authors noticed the Cox proportional hazard ratio comparing segmentectomy and lobectomy to wedge resection of 0.54 [95% confidence interval (CI): 0.37–0.77) and 0.44 (95% CI: 0.38–0.50), respectively, which suggested a significant improvement in survival.
• Observations revealed no difference in the 5-year survival of patients after lobectomy (79.1%; 95% CI: 77.7–80.4%) or segmentectomy (78.3%; 95% CI: 70.6–86.0%).
• For lobectomy, segmentectomy and wedge resection, the 30-day mortality rate was 1.6, 2.6 and 1.4%, respectively.
• A significantly lower 5-year survival rate was observed with wedge resection (58.1%; 95% CI: 53.6–62.5%) in comparison to segmentectomy (78.3%; 95% CI: 70.6–86.0%) and lobectomy (79.1%; 95% CI: 77.7–80.5%).
• The propensity score matched analysis supported most of the results of the comparisons of unmatched study groups.