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Ariane Steindl



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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.16-26 - Anatomic Segmentectomy in Stage I Non-Small-Cell Lung Cancer Reveals Equivalent Long-Term Outcomes Compared to Lobectomy (ID 14402)

      12:00 - 13:30  |  Author(s): Ariane Steindl

      • Abstract
      • Slides

      Background

      Lobectomy represents the prefered surgical procedure for patients with early stage non-small cell lung cancer (NSCLC). The choice for the right surgical procedure for stage I patients remains controversial. Aim of our study is to analyze short term and long term outcome of patients undergoing anatomic segmentectomy compared to lobectomy.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In this retrospective cohort study we included all patients with stage I NSCLC undergoing anatomic segmentectomy or lobectomy from 2006 until 2013 at your institution. A Propensity Score analysis was carried out with respect to age, gender, cardiovascular comorbidities, lung function (FEV1 >60%) and histology (adenocarcinoma vs squamous cell carcinoma). Overall survival and disease free survival as well as morbidity were endpoints of the study

      4c3880bb027f159e801041b1021e88e8 Result

      In total, 385 patients with peripheral located stage I NSCLC who neither underwent neoadjuvant nor adjuvant treatment were identified in our database. After applying propensity core matching, 47 patients underwent anatomic segmentectomy and lobectomy was performed in 47 patients. Of these 94 patients, 76 (81%), were in stage IA and 18 (19%) in stage IB. Adenocarcinoma was the histology in 67 (71%) patients and 27 (29%) patients had squamous cell lung cancer. 25 (27%) patients were operated by VATS and 69 (73%) patients underwent thoracotomy. In all patients, the postoperative complication rate was 11,7% and mean hospital stay was 9 days. There were no significant differences with regard to postopertative morbidity, 30- and 90-day mortality between the anatomic segmentectomy group and lobectomy group. 3- and 5-year overall survival (OS) were 79% vs. 84% and 69% vs. 76%., respectively. There was no significant difference between both groups regarding overall survival (p=0.302) and disease free survival (p=0.603). Interestingly , there was no significant difference in OS und disease free survival in both groups when tumor size was bigger than 2 cm( p=0.728 and p=0.432).

      8eea62084ca7e541d918e823422bd82e Conclusion

      The benefit of lobectomy over anatomic segmentectomy in patients with stage I NSCLC is still not clear. In our cohort, oncologic short- and long-term outcome of anatomic segmentectomy was comparable to outcome after lobectomy. However, the results of prospective randomized studies are warranted to clarify the value of sublobar resections for stage I NSCLC.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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