title: Does anatomical segmentectomy allow an adequate lymph node staging for cT1a non-small cell lung cancer?
abstract: BACKGROUND
  Anatomical segmentectomy is again under evaluation for the cure of T1a N0 non-small cell lung cancer and carcinoid tumors. Whether anatomical segmentectomy does permit or not, an adequate resection of nodal stations for staging or cure is still pending.
  
  
  METHODS
  A case-matched study was ruled on patients with peripheral cT1a N0 M0 tumors that underwent anatomical segmentectomy or lobectomy. Dissection of lymph node stations 4, 5, 6, and 7 was identical in anatomical segmentectomy and lobectomy; stations 10, 11, 12, and 13 were also dissected carefully during anatomical segmentectomy.
  
  
  RESULTS
  We individually matched 46 (69% men) anatomical segmentectomy with 46 (71% men) lobectomy for age, anatomical segment, and size of the tumor. The median (interquartile range) size of the resected lesions was 1.7 cm (1.35-1.95 cm) in anatomical segmentectomy and 1.6 cm (1.3-1.9 cm) (p = 0.96) in lobectomy. The anatomical segmentectomy and lobectomy resection margins were free of cancer. The median number (interquartile range) of total dissected lymph nodes was 12 (8-5-14) in anatomical segmentectomy compared with 13 (12-14.5) in lobectomy (p = 0.68), with a number of N1 nodes being 6 (4-7.5) and 7 (4.5-9.5) (p = 0.43), respectively, and N2 nodes 5.5 (4-7.7) and 5 (4-6.5) (p = 0.88). Only 1 patient of 46 (2%) anatomical segmentectomy was N1, whereas in lobectomy, 4% had N1 (2 patients). Freedom from recurrence at 36 months was 100% for anatomical segmentectomy and 93.5% for lobectomy (p = 0.33).
  
  
  CONCLUSIONS
  Anatomical segmentectomy for cT1a tumors compared with lobectomy procures an adequate number of N1 and N2 nodes for pathological examination. Cancer-specific survival was equivalent at 36 months.
authors.affiliation: Division of Thoracic Surgery, GVM Care and Research, Maria Cecilia Hospital Cotignola (Ra), Alma Mater Studiorum-University of Bologna, Bologna, Italy. sandro.mattioli@unibo.it
authors.forename: Sandro
authors.initials: S
authors.lastname: Mattioli
authors.forename: Alberto
authors.initials: A
authors.lastname: Ruffato
authors.forename: Francesco
authors.initials: F
authors.lastname: Puma
authors.forename: Niccolò
authors.initials: N
authors.lastname: Daddi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Aramini
authors.forename: Frank
authors.initials: F
authors.lastname: D'ovidio
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D015412:Mastectomy, Segmental; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome