- Segmentectomy offered similar OS to lobectomy in patients found to have node-positive stage I NSCLC.
- Patients who underwent lobectomy had higher rates of nodal upstaging than those who underwent segmentectomy.
Why this matters
- This study is the first to identify prognostic factors for nodal upstaging in early-stage NSCLC segmentectomy patients, including increasing tumor size, squamous cell histology, and increasing number of lymph nodes sampled.
- 4556 patients from the National Cancer Database with stage I NSCLC underwent segmentectomy (n=115) or lobectomy (n=4441) and found to have pathologic N stage I or II.
- Funding: None disclosed.
- No significant difference in 3-year OS between segmentectomy and lobectomy (66.3% vs 68.1%; HR, 0.91; P=.562).
- Lobectomy was associated with higher rates of nodal upstaging (9.5% vs 4.6%; P<.001>
- After multivariable analysis, significant predictors of node-positive disease after segmentectomy included increasing tumor size (OR, 2.13; P<.001 squamous cell histology p=".029)," and increasing number of lymph nodes sampled>
- Retrospective analysis.