Journal Articles European Journal of Cardio-Thoracic Surgery Year : 2024

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
Marco Alifano
Jean-Marc Baste
Maxime Heyndrickx
  • Function : Author
Agate Seguin-Givelet
  • Function : Author
Ahed Fallouh
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Ana Claudia Vlas
  • Function : Author
Antoine Defontaine
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Antoine Legras
  • Function : Author
Antonio Minniti
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Arnaud Pforr
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Aurelien Moret
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Axel Aubert
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Bastien Orsini
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Benoît Delepine
  • Function : Author
Benoît Lahon
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Bertrand Richard de Latour
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Bogdan Berbescu
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Boriana Pektova-Marteau
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Catalin Cosma
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Cedric Perrotin
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Christophe Berton
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Christophe Jayle
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Christophe Klein
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Christophe Lancelin
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Dan Angelescu
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David Kaczmarek
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Edouard Sage
Emmanuel Martinod
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Eric Brechet
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Eric de la Roche
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Eric Mensier
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Florence de Dominicis
Florence Mazeres
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Florent Charot
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Francoise Le Pimpec-Barthes
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Gaetan Singier
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Gilles Cardot
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Gilles Grosdidier
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Guillaume Boddaert
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Ilies Bouabdallah
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Jacques Jougon
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Jalal Assouad
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Jean François Levi
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Jean Marc Baste
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Jean Michel Maury
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Jean Philippe Arigon
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Jean-Noel Choplain
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Jean-Philippe Avaro
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Jean-Philippe Berthet
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Jean-Philippe Le Rochais
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Jocelyn Bellier
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Joel Riviere
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Karel Pfeuty
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Laurence Solovei
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Laurent Brouchet
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Lotfi Benhamed
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Lucia Mazzoni
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Luciano Eraldi
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Lucile Gust
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Madalina Grigoroiu
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Maher Dabboussi
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Marco Alifano
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Marion Durand
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Mathieu Coblence
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Matthieu Peret
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Mayeul Tabutin
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Michel Alauzen
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Myriam Ammi
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Nicola Santelmo
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Nicolas Venissac
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Nidal Alsit
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Olaf Mercier
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Olivier Aze
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Olivier Hagry
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Olivier Pagès
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Olivier Tiffet
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Pascal Thomas
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Patrick Bagan
  • Function : Author
Philippe Boitet
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Philippe Dalous
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Philippe Kleinmann
  • Function : Author
Philippe Lacoste
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Philippe Rinieri
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Pierre Mordant
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Pierre Tesson
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Pierre-Benoît Pages
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Pierre-Emmanuel Falcoz
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Pierre-Mathieu Bonnet
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Pierre-Yves Brichon
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Salam Abou Taam
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Sebastien Franco
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Sophie Guinard
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Sophie Jaillard-Thery
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Stéphane Renaud
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Valentine Anne
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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.

Domains

Surgery Cancer
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Dates and versions

hal-04826700 , version 1 (09-12-2024)

Identifiers

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Pascal Alexandre Thomas, Agathe Seguin-Givelet, Pierre-Benoît Pages, Marco Alifano, Laurent Brouchet, et al.. Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma. European Journal of Cardio-Thoracic Surgery, 2024, 66 (1), ⟨10.1093/ejcts/ezae251⟩. ⟨hal-04826700⟩
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