European prognosis evaluation of early-stage lung adenocarcinoma patterns after lobectomy versus segmentectomy based on clinical stage settings

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Objectives: To investigate the prognosis of peripheral early-stage lung adenocarcinoma patterns treated by lobectomy or segmentectomy. Methods: Retrospective multicentric cohort of patients with cT1a-bN0M0 lung adenocarcinoma who underwent lobectomy or segmentectomy with systematic lymph node dissection in 10 European centers (one per country) from 2015 to 2021. Overall survival (OS), disease-free survival (DFS), and lung cancer-specific death (LCSD) between both groups were assessed in entire dataset and in dataset of histologic aggressive patterns, before and after propensity score-matching (PSM). Prognostic risk factors were analyzed using parsimonious model Cox regression. Recurrences were assessed by linearized risks. Results: = .8. Locoregional recurrence was not superior in patients who underwent segmentectomy in entire dataset (linearized risks: lobectomy 0.078, segmentectomy 0.073) and in aggressive dataset (linearized risks: lobectomy 0.036, segmentectomy 0.011) only in the unmatched cohorts. Aggressive histologic patterns impacted on only LCSD, and only when they were dominant. Conclusions: Segmentectomy seems comparable to lobectomy for patients with peripheral cT1a-bN0M0 lung adenocarcinoma even in case of histologic aggressive patterns.

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