title: Recurrence and Survival After Segmentectomy in Patients With Prior Lung Resection for Early-Stage Non-Small Cell Lung Cancer.
abstract: BACKGROUND
  Lobectomy is the standard of care for patients with early-stage non-small cell lung cancer (NSCLC). However, the treatment of choice for patients with prior lung resection and a second primary NSCLC has not been established. We compared rates and patterns of recurrence and survival in patients with and without prior lung resection treated by segmentectomy and determined predictors of recurrence.
  
  
  METHODS
  This was a retrospective cohort study of 90 patients who underwent 91 consecutive segmentectomies for early-stage NSCLC between April 2004 and December 2014. Logistic regression was used to determine predictors of recurrence, and Kaplan-Meier curves were used to determine survival.
  
  
  RESULTS
  Of the 91 segmentectomies, 21 (23%) had a prior lung cancer resection and 70 (77%) were primary resections. There were 18 recurrences (20%): 9 of 21 (43%) in those with prior lung resection and 9 of 70 (13%) in those without. The 90-day mortality was 0%. The recurrence-free survival and 5-year survival were 61% and 55% in those with prior lung resection (p = 0.09) and 84% and 65% in those without (p = 0.4). Close parenchymal margin and number of lymph nodes examined were significant modifiable predictors of recurrence.
  
  
  CONCLUSIONS
  Segmentectomy is a reasonable option for patients with early-stage NSCLC who have had a prior lung resection. It results in similar survival but trends toward lower recurrence-free survival compared with patients undergoing primary resection.
authors.affiliation: Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, University of California, Davis Medical Center, Sacramento, California.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Brown
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington. Electronic address: brian.louie@swedish.org.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Louie
authors.affiliation: Department of Cardiothoracic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
authors.forename: Nicole
authors.initials: N
authors.lastname: Jackson
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Farivar
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Aye
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
authors.forename: Eric
authors.initials: E
authors.lastname: Vallières
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome