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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, November 6, 2024
According to Zhengshui Xu, MD, of the Second Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China, and colleagues, there is no established consensus as to whether the survival benefit of lobectomy in early-stage non–small cell lung cancer (NSCLC) is comparable to that of wedge resection. To provide a recommendation for surgical interventions, these researchers compared survival benefits among patients undergoing these procedures. Their results were published in Scientific Reports.
“For early-stage NSCLC patients with tumor size ≤ 1 cm or ≤ 2 cm with grade 1 [tumor differentiation], there was no significant difference in survival between wedge resection and lobectomy,” the authors concluded. “Therefore, wedge resection may be considered as an alternative to lobectomy in NSCLC patients with T1aN0M0 or well-differentiated T1bN0M0.”
The investigators focused on data from the Surveillance, Epidemiology, and End Results (SEER) Project data; 3,891 patients with early-stage NSCLC and tumors of ≤ 2.0 cm were enrolled. Of the total, 2,839 underwent lobectomy, and 1,052 underwent wedge resection. Cox proportional hazard models and Kaplan-Meier curves were used to assess lung cancer–specific survival and overall survival, respectively. Patients with tumors > 2.0 cm, as well as those who received radiotherapy or chemotherapy, were excluded from the study.
Regardless of propensity score matching, unstratified patients who underwent lobectomy experienced significantly longer lung cancer–specific survival and overall survival rates than did those who received wedge resection. As for patients with tumors ≤ 1.0 cm, lobectomy alone yielded a significantly better survival rate over wedge resection before propensity score matching (P < .05).
This trend continued among patients with grade 1 tumor differentiation, further suggesting the superiority of lobectomy to wedge resection in improving lung cancer–specific survival (P = .038). Of note, overall survival was not found to be significantly different between treatment groups, and neither procedure was inferior to the other after propensity score matching.
Disclosure: The study authors reported no conflicts of interest
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