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Does Anatomical Segmentectomy Allow an Adequate Lymph Node Staging for cT1a Non-small Cell Lung Cancer?
MedLine Citation:
PMID:  21642864     Owner:  NLM     Status:  Publisher    
INTRODUCTION:: Anatomical segmentectomy is again under evaluation for the cure of T1a N0 non-small cell lung cancer and carcinoid tumors. Whether anatomical segmentectomy does permit or not, an adequate resection of nodal stations for staging or cure is still pending. METHODS:: A case-matched study was ruled on patients with peripheral cT1a N0 M0 tumors that underwent anatomical segmentectomy or lobectomy. Dissection of lymph node stations 4, 5, 6, and 7 was identical in anatomical segmentectomy and lobectomy; stations 10, 11, 12, and 13 were also dissected carefully during anatomical segmentectomy. RESULTS:: We individually matched 46 (69% men) anatomical segmentectomy with 46 (71% men) lobectomy for age, anatomical segment, and size of the tumor. The median (interquartile range) size of the resected lesions was 1.7 cm (1.35-1.95 cm) in anatomical segmentectomy and 1.6 cm (1.3-1.9 cm) (p = 0.96) in lobectomy. The anatomical segmentectomy and lobectomy resection margins were free of cancer. The median number (interquartile range) of total dissected lymph nodes was 12 (8-5-14) in anatomical segmentectomy compared with 13 (12-14.5) in lobectomy (p = 0.68), with a number of N1 nodes being 6 (4-7.5) and 7 (4.5-9.5) (p = 0.43), respectively, and N2 nodes 5.5 (4-7.7) and 5 (4-6.5) (p = 0.88). Only 1 patient of 46 (2%) anatomical segmentectomy was N1, whereas in lobectomy, 4% had N1 (2 patients). Freedom from recurrence at 36 months was 100% for anatomical segmentectomy and 93.5% for lobectomy (p = 0.33). CONCLUSIONS:: Anatomical segmentectomy for cT1a tumors compared with lobectomy procures an adequate number of N1 and N2 nodes for pathological examination. Cancer-specific survival was equivalent at 36 months.
Sandro Mattioli; Alberto Ruffato; Francesco Puma; Niccolò Daddi; Beatrice Aramini; Frank Dʼovidio
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-2
Journal Detail:
Title:  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer     Volume:  -     ISSN:  1556-1380     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274235     Medline TA:  J Thorac Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Division of Thoracic Surgery, GVM Care and Research, Maria Cecilia Hospital Cotignola (Ra), Alma Mater Studiorum-University of Bologna, Bologna, Italy; †Division of Thoracic Surgery, S. Maria della Misericordia University Hospital, University of Perugia, Perugia, Italy; ‡Pneumo-Cardio-Thoracic Sciences, Division of Thoracic Surgery, GVM Care and Research, Maria Cecilia Hospital Cotignola (Ra), Alma Mater Studiorum-University of Bologna, Bologna, Italy; and §Division of Cardiothoracic Surgery, Columbia University, New York City, New York.
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