Node-Positive Segmentectomy for Non-Small-Cell Lung Cancer: Risk Factors and Outcomes.
Publication/Presentation Date
7-1-2019
Abstract
BACKGROUND: Segmentectomy for well-selected early stage non-small-cell lung carcinoma (NSCLC) has been shown to have similar oncologic outcomes and survival to lobectomy. However, these data are based on the presumption that the disease is node negative. Few data exist regarding the risk factors for and the outcomes of patients with disease treated with segmentectomy that is found to be node positive. We sought to determine the risk factors for and outcomes of clinical stage I NSCLC patients who are treated with segmentectomy but are determined to be node positive.
PATIENTS AND METHODS: We queried patients with clinical stage I NSCLC ≤ 3 cm within the National Cancer Data Base between 2004 and 2014 who were treated with segmentectomy or lobectomy and found to have positive nodes. Kaplan-Meier curves with log-rank tests were used to compare overall survival (OS) between segmentectomy and lobectomy. For comparison only, segmentectomy patients with pathologically node-negative disease were identified to determine predictors of node positivity after segmentectomy via multivariable logistic regression.
RESULTS: A total of 4556 patients with node-positive disease were identified, comprising 115 segmentectomy patients and 4441 lobectomy patients. Multivariable analysis identified increasing tumor size, squamous-cell histology, and increasing number lymph nodes sampled as significant predictors of node positivity after segmentectomy. There was no difference in OS between segmentectomy and lobectomy, with 3-year OS rates of 66.3% and 68.1%, respectively (P = .723).
CONCLUSION: There are discrete risk factors for discovering positive nodes after segmentectomy. Segmentectomy is associated with similar OS compared to lobectomy for clinical stage I NSCLC found to be node positive.
Volume
20
Issue
4
First Page
463
Last Page
463
ISSN
1938-0690
Published In/Presented At
Lutfi, W., Schuchert, M. J., Dhupar, R., Ekeke, C., Sarkaria, I. S., Christie, N. A., Luketich, J. D., & Okusanya, O. T. (2019). Node-Positive Segmentectomy for Non-Small-Cell Lung Cancer: Risk Factors and Outcomes. Clinical lung cancer, 20(4), e463–e469. https://doi.org/10.1016/j.cllc.2019.03.006
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
31031205
Department(s)
Administration and Leadership
Document Type
Article