ArticleThe Annals of thoracic surgery2024
Outcomes of Patients Undergoing Segmentectomy for Occult Node-Positive Clinical Stage IA Lung Cancer.
Article in The Annals of thoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed.
- Routine intraoperative frozen section assessment of lymph nodes in clinical stage IA non-small cell lung cancer: towards a risk-stratified approach.Journal of thoracic disease · 2026Article
- The cost of knowing: should frozen section pathology be used routinely for the assessment of lymph nodes in clinical stage IA non-small cell lung cancer?Journal of thoracic disease · 2026Article
- Local Recurrence After Lung Segmentectomy-Risk Factors and Future Directions: A Contemporary Review.Cancers · 2026Review
- Thoracoscopic Incomplete Anatomical Segmentectomy for Ground-Glass-Dominant Lung Cancer: Associations with Lower Postoperative Cough Burden and Faster Symptom Recovery.Annals of surgical oncology · 2026Article
- Sublobar resection combined with furmonertinib in peripheral solid EGFR-mutated stage IA3 lung adenocarcinoma patients with pulmonary dysfunction: a retrospective multi-institutional study.Journal of thoracic disease · 2026Article
- Nodal Upstaging and Oncologic Outcomes After Segmentectomy Versus Lobectomy for Early-Stage Non-Small Cell Lung Cancer.Cancers · 2026Review
- Surgical Challenge of Sublobar Resection for Early-stage Non-small Cell Lung Cancer: Current Status and Future Perspectives.Juntendo medical journal · 2026Article
- Unforeseen nodal upstaging in patients undergoing segmentectomy without frozen section: a multicenter retrospective cohort study.Surgical endoscopy · 2025Article
- Pathologic upstaging and survival outcomes for patients undergoing segmentectomy versus lobectomy in clinical stage T1cN0M0 non-small cell lung cancer.JTCVS open · 2025Article
- Analysis of lymph node metastasis based on consolidation tumor ratio and maximum standardized uptake value in clinical stage IA non-small cell lung cancer.Journal of thoracic disease · 2025Article
- Case report: Occult lymph nodal metastasis in sub-centimeter lung cancer: a report of seven cases and review of literature.Frontiers in oncology · 2025Article
- An innovative and safe method to manage the inter-segmental plane using the "Inserted Multilateral Cutting Method" in pulmonary segmentectomy.Journal of thoracic disease · 2024Article
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Abstract
backgroundResults of recent clinical trials suggest that segmentectomy may be an acceptable alternative to lobectomy for selected patients with early-stage non-small cell lung cancer (NSCLC). Increased use of segmentectomy may result in a concomitant increase in occult node-positive (N+) disease on surgical pathology examination. The optimal management for such patients remains unknown.
methodsClinicopathologic data were abstracted from a prospective institutional database to identify patients with pathologic N+ disease after segmentectomy for cT1 N0 M0 NSCLC. Propensity score matching identified a comparable lobectomy cohort for assessment of cumulative incidence of recurrence and overall survival (OS).
resultsOf 759 included patients, 27 (4%) had nodal upstaging on the final pathology report. Of these 27 patients, 4 (15%) had skip metastasis to N2 stations, and 20 (74%) received adjuvant therapy; no completion lobectomies were performed. Ten patients (37%) had disease recurrence: 3 isolated locoregional (11%) and 7 distant (26%). The median time to recurrence among patients with recurrence was 1.8 years; OS after recurrence was 3.4 years. After 5:1 matching with 109 patients who underwent lobectomy, all variables were balanced between the groups, except pathologic N2 stage and open surgical approach. The 5-year cumulative incidence of recurrence was not significantly different between segmentectomy and lobectomy (42% vs 52%, respectively; Gray's P = .1). The 5-year OS (63% and 50%) and rate of locoregional recurrence (12% vs 13%) were not statistically different between the groups.
conclusionsPatients with occult N+ disease after segmentectomy for cT1 N0 M0 NSCLC had limited isolated locoregional recurrences and outcomes similar to those in patients who underwent lobectomy. Lobectomy may not provide an advantage in these patients.
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