ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025
Real-World Outcomes of Limited Resection for Tumours Greater Than 20 mm in Non-Small Cell Lung Cancer.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesSublobar resection is an established surgical option for early-stage non-small cell lung cancer. However, evidence remains limited regarding its use for tumours >20 mm in real-world settings. We evaluated characteristics and outcomes of limited resection in this context and identified predictors of local recurrence.
methodsWe retrospectively analysed 165 patients with clinical stage I non-small cell lung cancer with tumours >20 mm who underwent limited resection between 2007 and 2017. Clinical, pathological, and radiological data were reviewed. The primary end-point was local recurrence, assessed using competing risk analysis. Overall survival and disease-free survival were estimated using Kaplan-Meier and Cox models.
resultsWe analysed 165 patients with 13 local recurrence events. Among them, 146 (88.5%) had identifiable reasons for not undergoing lobectomy. Segmentectomy and wedge resection were performed in 59% and 41% of cases, respectively. Lymph node dissection was performed in all segmentectomies and in 20% of wedge resections. The 5-year overall and disease-free survival rates were 64.0% and 62.1%. Local recurrence occurred in 8%, more frequently after wedge resection than segmentectomy (13% vs 4%, P = .04). Solid-predominant tumours with a consolidation-to-tumour ratio greater than 0.5 accounted for 76% and were independently associated with lower disease-free survival (hazard ratio, 2.65; P = .05) and higher local recurrence (hazard ratio: infinite; P < .001). No local recurrence was observed in tumours with a ground-glass opacity-predominant pattern.
conclusionsLimited resection showed acceptable outcomes in lung cancers >20 mm, especially with ground-glass opacity; solid-predominant CT patterns were strongly linked to recurrence.
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