Patient-Reported Outcomes: Wedge Resection vs Uniportal Thoracoscopic Segmentectomy for Peripheral NSCLC

By: Vanessa A. Carter, BS
Posted: Tuesday, June 25, 2024

Tianpeng Xie, MD, PhD, of Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Chengdu, China, and colleagues analyzed patient-reported outcomes such as symptom burden in patients with non–small cell lung cancer (NSCLC) who underwent uniportal thoracoscopic segmentectomy or wedge resection. Published in the Journal of Cardiothoracic Surgery, the findings from this study support the addition of wedge resection to thoracoscopic segmentectomy for peripheral NSCLC (tumor diameter ≤ 2 cm and consolidation tumor ratio ≤ 0.5).

“The results of this study revealed that uniportal thoracoscopic segmentectomy and wedge resection exhibited comparable early postoperative symptom burden for patients with peripheral NSCLC nodules [no more than] 2 cm in diameter and consolidation tumor ratio [of at most] 0.5,” the study authors mentioned. “...Wedge resection demonstrated superior short-term clinical outcomes in comparison to segmentectomy.”

This study enrolled 347 patients with peripheral NSCLC from the CN-PRO-Lung 3 cohort who underwent segmentectomy (n = 286) or wedge resection (n = 61). Patients had a tumor diameter of at most 2 cm and a consolidation tumor ratio of no more than 0.5. The Perioperative Symptom Assessment for Lung Surgery questionnaire was given to patients preoperatively, daily for 4 days after surgery, and weekly after hospital discharge for 4 weeks.

The median patient age was 49.5 years, with the majority of patients being female (73.8%) and nonsmokers (84.9%). Patient demographics were consistent between groups. There were no significant differences identified between groups regarding moderate-to-severe symptoms and mean scores for disturbed sleep, drowsiness, cough, pain, shortness of breath, fatigue, and distress during the postoperative and postdischarge periods. However, wedge resection demonstrated better short-term outcomes than segmentectomy, including less intraoperative bleeding (P = .046), lower hospital costs (P = .002), and shorter operative time (P = .001).

Disclosure: The study authors reported no conflicts of interest.

Journal of Cardiothoracic Surgery