Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma
Pascal Alexandre Thomas
(1, 2)
,
Agathe Seguin-Givelet
(3)
,
Pierre-Benoît Pages
(4, 5)
,
Marco Alifano
(6, 7)
,
Laurent Brouchet
(8)
,
Pierre-Emmanuel Falcoz
(9)
,
Jean-Marc Baste
(10)
,
Matthieu Glorion
(11, 12)
,
Yaniss Belaroussi
(13)
,
Marc Filaire
(14, 15, 16)
,
Maxime Heyndrickx
,
Anderson Loundou
(17)
,
Alex Fourdrain
(18, 2)
,
Marcel Dahan
(8)
,
Laurent Boyer
(19)
,
Agate Seguin-Givelet
,
Ahed Fallouh
,
Albéric de Lambert
(20)
,
Ana Claudia Vlas
,
Antoine Claret
(21)
,
Antoine Defontaine
(22)
,
Antoine Legras
,
Antonio Minniti
,
Arnaud Pforr
,
Aurelien Moret
,
Axel Aubert
,
Bastien Orsini
,
Benoît Delepine
,
Benoît Lahon
,
Bertrand Richard de Latour
,
Bogdan Berbescu
,
Boriana Pektova-Marteau
,
Catalin Cosma
,
Cedric Perrotin
,
Christophe Berton
,
Christophe Jayle
,
Christophe Klein
,
Christophe Lancelin
,
Dan Angelescu
,
David Kaczmarek
,
Edouard Sage
,
Emmanuel Martinod
,
Eric Brechet
,
Eric de la Roche
,
Eric Mensier
,
Florence de Dominicis
,
Florence Mazeres
,
Florent Charot
,
Francoise Le Pimpec-Barthes
,
Gaetan Singier
,
Gilles Cardot
,
Gilles Grosdidier
,
Guillaume Boddaert
,
Ilies Bouabdallah
,
Jacques Jougon
,
Jalal Assouad
,
Jean François Levi
,
Jean Marc Baste
,
Jean Michel Maury
,
Jean Philippe Arigon
,
Jean-Noel Choplain
,
Jean-Philippe Avaro
,
Jean-Philippe Berthet
,
Jean-Philippe Le Rochais
,
Jocelyn Bellier
,
Joel Riviere
,
Karel Pfeuty
,
Laurence Solovei
,
Laurent Brouchet
,
Lotfi Benhamed
,
Lucia Mazzoni
,
Luciano Eraldi
,
Lucile Gust
,
Madalina Grigoroiu
,
Maher Dabboussi
,
Marc Filaire
(14, 15, 16)
,
Marco Alifano
,
Marion Durand
,
Mathieu Coblence
,
Matthieu Peret
,
Mayeul Tabutin
,
Michel Alauzen
,
Myriam Ammi
,
Nicola Santelmo
,
Nicolas Venissac
,
Nidal Alsit
,
Olaf Mercier
,
Olivier Aze
,
Olivier Hagry
,
Olivier Pagès
,
Olivier Tiffet
,
Pascal Thomas
,
Patrick Bagan
,
Philippe Boitet
,
Philippe Dalous
,
Philippe Kleinmann
,
Philippe Lacoste
,
Philippe Rinieri
,
Pierre Mordant
,
Pierre Tesson
,
Pierre-Benoît Pages
,
Pierre-Emmanuel Falcoz
,
Pierre-Mathieu Bonnet
,
Pierre-Yves Brichon
,
Salam Abou Taam
,
Sebastien Franco
,
Sophie Guinard
,
Sophie Jaillard-Thery
,
Stéphane Renaud
,
Valentine Anne
,
Vincent Blin
,
Vincent Casanova
,
Xavier de Kerangal
1
CRCM -
Centre de Recherche en Cancérologie de Marseille
2 Hôpital Nord [CHU - APHM]
3 IMM - Institut Mutualiste de Montsouris
4 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
5 Hôpital du Bocage
6 Hôpital Cochin [AP-HP]
7 UPCité - Université Paris Cité
8 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
9 NanoRegMed - Nanomédecine Régénérative
10 CHU Rouen
11 Hôpital Foch [Suresnes]
12 VIM (UR 0892) - Virologie et Immunologie Moléculaires
13 BPH - Bordeaux population health
14 UNH - Unité de Nutrition Humaine
15 Département Chirurgie Thoracique et Endocrinienne [Centre Jean Perrin - Clermont-Ferrand]
16 UCA - Université Clermont Auvergne
17 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
18 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
19 C3M - Caractérisation et Modélisation Multi-échelle, Multi-physique
20 Département de chirurgie thoracique, vasculaire et endocrinienne
21 CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
22 CH de Quimper
2 Hôpital Nord [CHU - APHM]
3 IMM - Institut Mutualiste de Montsouris
4 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
5 Hôpital du Bocage
6 Hôpital Cochin [AP-HP]
7 UPCité - Université Paris Cité
8 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
9 NanoRegMed - Nanomédecine Régénérative
10 CHU Rouen
11 Hôpital Foch [Suresnes]
12 VIM (UR 0892) - Virologie et Immunologie Moléculaires
13 BPH - Bordeaux population health
14 UNH - Unité de Nutrition Humaine
15 Département Chirurgie Thoracique et Endocrinienne [Centre Jean Perrin - Clermont-Ferrand]
16 UCA - Université Clermont Auvergne
17 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
18 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
19 C3M - Caractérisation et Modélisation Multi-échelle, Multi-physique
20 Département de chirurgie thoracique, vasculaire et endocrinienne
21 CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
22 CH de Quimper
Pascal Alexandre Thomas
- Function : Author
- PersonId : 774955
- ORCID : 0000-0002-3305-6989
Agathe Seguin-Givelet
- Function : Author
- PersonId : 796752
- ORCID : 0000-0002-2906-4433
Marco Alifano
- Function : Author
- PersonId : 1069308
- ORCID : 0000-0002-2038-1037
- IdRef : 136322859
Matthieu Glorion
- Function : Author
- PersonId : 1179767
- ORCID : 0000-0002-3233-860X
Marc Filaire
- Function : Author
- PersonId : 1475811
- IdHAL : marc-filaire
Maxime Heyndrickx
- Function : Author
Anderson Loundou
- Function : Author
- PersonId : 760704
- ORCID : 0000-0003-4301-9476
Alex Fourdrain
- Function : Author
- PersonId : 1368903
- ORCID : 0000-0001-6431-3899
- IdRef : 235247677
Agate Seguin-Givelet
- Function : Author
Ahed Fallouh
- Function : Author
Ana Claudia Vlas
- Function : Author
Antoine Legras
- Function : Author
Antonio Minniti
- Function : Author
Arnaud Pforr
- Function : Author
Aurelien Moret
- Function : Author
Axel Aubert
- Function : Author
Bastien Orsini
- Function : Author
Benoît Delepine
- Function : Author
Benoît Lahon
- Function : Author
Bertrand Richard de Latour
- Function : Author
Bogdan Berbescu
- Function : Author
Boriana Pektova-Marteau
- Function : Author
Catalin Cosma
- Function : Author
Cedric Perrotin
- Function : Author
Christophe Berton
- Function : Author
Christophe Jayle
- Function : Author
Christophe Klein
- Function : Author
Christophe Lancelin
- Function : Author
Dan Angelescu
- Function : Author
David Kaczmarek
- Function : Author
Edouard Sage
- Function : Author
- PersonId : 1135354
- IdHAL : edouard-sage
- ORCID : 0000-0001-7654-474X
- IdRef : 110431979
Emmanuel Martinod
- Function : Author
Eric Brechet
- Function : Author
Eric de la Roche
- Function : Author
Eric Mensier
- Function : Author
Florence de Dominicis
- Function : Author
- PersonId : 1481142
- ORCID : 0009-0000-1189-9849
- IdRef : 158142292
Florence Mazeres
- Function : Author
Florent Charot
- Function : Author
Francoise Le Pimpec-Barthes
- Function : Author
Gaetan Singier
- Function : Author
Gilles Cardot
- Function : Author
Gilles Grosdidier
- Function : Author
Guillaume Boddaert
- Function : Author
Ilies Bouabdallah
- Function : Author
Jacques Jougon
- Function : Author
Jalal Assouad
- Function : Author
Jean François Levi
- Function : Author
Jean Marc Baste
- Function : Author
Jean Michel Maury
- Function : Author
Jean Philippe Arigon
- Function : Author
Jean-Noel Choplain
- Function : Author
Jean-Philippe Avaro
- Function : Author
Jean-Philippe Berthet
- Function : Author
Jean-Philippe Le Rochais
- Function : Author
Jocelyn Bellier
- Function : Author
Joel Riviere
- Function : Author
Karel Pfeuty
- Function : Author
Laurence Solovei
- Function : Author
Laurent Brouchet
- Function : Author
Lotfi Benhamed
- Function : Author
Lucia Mazzoni
- Function : Author
Luciano Eraldi
- Function : Author
Lucile Gust
- Function : Author
Madalina Grigoroiu
- Function : Author
Maher Dabboussi
- Function : Author
Marco Alifano
- Function : Author
Marion Durand
- Function : Author
Mathieu Coblence
- Function : Author
Matthieu Peret
- Function : Author
Mayeul Tabutin
- Function : Author
Michel Alauzen
- Function : Author
Myriam Ammi
- Function : Author
Nicola Santelmo
- Function : Author
Nicolas Venissac
- Function : Author
Nidal Alsit
- Function : Author
Olaf Mercier
- Function : Author
Olivier Aze
- Function : Author
Olivier Hagry
- Function : Author
Olivier Pagès
- Function : Author
Olivier Tiffet
- Function : Author
Pascal Thomas
- Function : Author
Patrick Bagan
- Function : Author
Philippe Boitet
- Function : Author
Philippe Dalous
- Function : Author
Philippe Kleinmann
- Function : Author
Philippe Lacoste
- Function : Author
Philippe Rinieri
- Function : Author
Pierre Mordant
- Function : Author
Pierre Tesson
- Function : Author
Pierre-Benoît Pages
- Function : Author
Pierre-Emmanuel Falcoz
- Function : Author
Pierre-Mathieu Bonnet
- Function : Author
Pierre-Yves Brichon
- Function : Author
Salam Abou Taam
- Function : Author
Sebastien Franco
- Function : Author
Sophie Guinard
- Function : Author
Sophie Jaillard-Thery
- Function : Author
Stéphane Renaud
- Function : Author
Valentine Anne
- Function : Author
Vincent Blin
- Function : Author
Vincent Casanova
- Function : Author
Xavier de Kerangal
- Function : Author
Abstract
Abstract OBJECTIVES To determine safety and survival outcomes associated with lobectomy, segmentectomy and wedge resection for early-stage lung cancer by quiring the French population-based registry EPIdemiology in THORacic surgery (EPITHOR). METHODS Retrospective analysis of 19 452 patients with stage c IA lung carcinoma who underwent lobectomy, segmentectomy or wedge resection between 2016 and 2022 with curative-intent. Main outcome measures were 90-day mortality and 5-year overall survival estimates. Proportional hazards regression and propensity score matching were used to adjust outcomes for key patient, tumour and practice environment factors. RESULTS The treatment distribution was 72.2% for lobectomy, 21.5% for segmentectomy and 6.3% for wedge. Unadjusted 90-day mortality rates were 1.6%, 1.2% and 1.1%, respectively (P = 0.10). Unadjusted 5-year overall survival estimates were 80%, 78% and 70%, with significant inter-group survival curves differences (P < 0.0001). Multivariable proportional hazards regression showed that wedge was associated with worse overall survival [adjusted hazard ratio (AHR), 1.23 (95% confidence interval 1.03–1.47); P = 0.021] compared with lobectomy, while no significant difference was disclosed when comparing segmentectomy to lobectomy (1.08 [0.97–1.20]; P = 0.162). The three-way propensity score analyses confirmed similar 90-day mortality rate for wedge resection and segmentectomy compared with lobectomy (hazard ratio: 0.43; 95% confidence interval 0.16–1.11; P = 0.081 and 0.99; 0.48–2.10; P = 0.998, respectively), but poorer overall survival (1.45; 1.13–1.86; P = 0.003 and 1.31; 1–1.71; P = 0.048, respectively). CONCLUSIONS Wedge resection was associated with comparable 90-day mortality but lower overall survival when compared to lobectomy. Overall, all types of sublobar resections may not offer equivalent oncologic effectiveness in real-world settings.