title: Outcomes of segmentectomy for cT1bN0M0 lung adenocarcinoma and squamous cell carcinoma: a possible association with pathological invasion.
abstract: OBJECTIVE
  We evaluated the clinical benefit of segmentectomy for patients with cT1bN0M0 lung cancer.
  
  
  METHODS
  We retrospectively reviewed the medical records of 178 patients who underwent lobectomy or segmentectomy for cT1bN0M0 lung adenocarcinoma and squamous cell carcinoma from January 1995 to December 2005. We investigated the association of surgical outcomes with the presence of pathological invasion.
  
  
  RESULTS
  The median follow-up period was 93.4 months. Of 178 patients, 37 were scheduled for segmentectomy, but 6 of these patients were switched to receive lobectomy due to surgical N1 or N2 in 3 patients and insufficient surgical margins in 3 patients. In total, 31 patients underwent segmentectomy, and 147 underwent lobectomy. The 5-year overall survival (OS) was similar between the patients who underwent lobectomy (5-year OS, 81.6%) and segmentectomy (5-year OS, 77.4%, P = 0.73). Among pN0 patients without pathological invasion, there was no difference in OS between patients who underwent lobectomy (5-year OS, 89.9%) and segmentectomy (5-year OS, 88.9%, P = 0.80). In contrast, among pN0 patients with pathological invasion, OS was greater in patients who underwent lobectomy (5-year OS, 80.9%) than in those who underwent segmentectomy (5-year OS, 54.6%; P = 0.19). Moreover, a significantly higher rate of local and local + distant recurrence was observed in patients who underwent segmentectomy (45%) than in those who underwent lobectomy (15%) in this group (P = 0.02).
  
  
  CONCLUSIONS
  The results of our study suggest that segmentectomy may not be recommended for cT1b tumours if pathological invasion is suspected before surgery.
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan kazuya-uchino@hp.pref.hyogo.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Uchino
authors.affiliation: Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Shimizu
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okuda
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Tane
authors.affiliation: Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hokka
authors.affiliation: Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tane
authors.affiliation: Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tauchi
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Nishio
authors.affiliation: Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Maniwa
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011013:Pneumonectomy / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Diagnosis; Lobectomy; Lung cancer; Lung cancer surgery; Segmentectomy; Wedge resection