Virtual Library

Start Your Search

Taisuke Kaiho



Author of

  • +

    P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P2.16-44 - Long-Term Outcome of Pulmonary Segmentectomy for c-IA Non-Small Cell Lung Cancer (ID 14202)

      16:45 - 18:00  |  Author(s): Taisuke Kaiho

      • Abstract

      Background

      Pulmonary segmentectomy is being accepted as a favorable treatment option for small peripheral non-small cell lung cancer (NSCLC) although lobectomy is the standard surgical procedure. The long-term outcome and related issues in remote phase after pulmonary segmentectomy needs to be investigated.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed 135 and 313 patients with clinical (c-) stage IA NSCLC who underwent segmentectomy (S) or lobectomy (L) from January 2008 to December 2015. Patient characteristics, prognosis, recurrence sites, and occurrence of second primary lung cancer were reviewed and compared between the 2 groups. Segmentectomy was intentionally selected when a target tumor was less than 3cm in diameter and ground-glass predominant. Solid part predominant tumors were also eligible for segmentectomy if its diameter was 2cm or less. Segmentectomy was reluctantly selected instead of lobectomy if patients presented insufficient vital organ function or have other pulmonary lesions which needed to be removed.

      4c3880bb027f159e801041b1021e88e8 Result

      In segmentectomy group, the average age was 68.1± 9.1 and 74 males were included. The solid tumor diameter and consolidation-tumor ratio in the S group were statistically smaller than those in the L group. There were no statistical differences in 5-year overall survival (S: 92.0% vs L: 91.5%) and relapse-free survival (5y-RFS) (S: 87.9% vs L: 84.4%) between the 2groups. The 5-year RFS stratified by clinical T factors in 8th edition showed no statistical differences between the 2 groups. Tumor recurrence occurred in 14 patients (10.4%), including loco-regional in 11 (8.1%) and distant metastasis in 3 (2.2%) patients. Recurrence on the intersegmental plane was developed in 2 patients. Loco-regional recurrence rates were similar in the 2 groups; however, loco-regional recurrence after segmentectomy tended to arise later than those after lobectomy (median of loco-regional recurrence free survival: 1094 and 512 days). Multi-variate analysis showed that a risk factor for loco-regional recurrence was solid tumor diameter, not segmentectomy. Second primary lung cancer occurred in 7 and 12 patients after segmentectomy and lobectomy, respectively. Additional lung resection including completion lobectomy was applied and showed better outcome than non-surgical treatment.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The long-term outcome of segmentectomy for selected patients is equivalent to those of lobectomy. However, careful follow-up is mandatory as recurrence and second primary lung cancer can occur in the same lobe after segmentectomy which is avoidable by lobectomy.

      6f8b794f3246b0c1e1780bb4d4d5dc53