title: Locoregional recurrence after segmentectomy for clinical-T1aN0M0 radiologically solid non-small-cell lung carcinoma.
abstract: We aimed to identify the clinicopathological features of loco-regional recurrence after segmentectomy for clinical-T1aN0M0 radiologically invasive non-small-cell lung carcinoma (NSCLC).
  
  
  
  Between 2008 and 2014, 353 patients underwent pulmonary lobectomy or segmentectomy with nodal dissection for clinical-T1aN0M0 radiologically invasive NSCLC showing 0.5 ≤ consolidation tumour ratio (CTR)≤1.0 on thin-section computed tomography (CT). Radiological invasive NSCLC was divided into two groups, i.e. part-solid (0.5 ≤ CTR < 1.0) and pure-solid (CTR = 1.0). Significant prognostic factors for oncological outcomes were evaluated by multivariate analysis.
  
  
  
  Lobectomy was performed in 270 (76.5%) patients and segmentectomy in 83 (23.5%). Locoregional recurrence-free survival (LRFS) of clinical-T1a radiologically invasive NSCLC on the whole showed no significant differences between the lobectomy and segmentectomy arms (3-year LRFS, 93.0 vs 90.1%, P  = 0.2725). In contrast, the multivariate analysis revealed that radiologically pure-solid appearance and tumour size were significant predictors of loco-regional recurrence ( P  = 0.0106, 0.0408). Among 212 clinical-T1a radiologically pure-solid NSCLCs, frequency of loco-regional recurrence was high in the segmentectomy arm (20.7%) compared with that of lobectomy arm (8.2%). Furthermore, segmentectomy and larger tumour size were independent significant clinical factors of loco-regional recurrence based on the multivariate analysis ( P  = 0.0292, 0.0402). The 3-year LRFS of the segmentectomy arm was significantly worse than that of the lobectomy arm in the c-T1a disease (82.2 vs 90.6%, P  = 0.0488) provided the tumour showed a pure-solid appearance.
  
  
  
  Even in cases of small-sized lung carcinoma, segmentectomy should be applied with great caution especially for a radiological pure-solid NSCLC on thin-section CT due to their high incidence of loco-regional recurrence.
authors.affiliation: Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Aritoshi
authors.initials: A
authors.lastname: Hattori
authors.affiliation: Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsunaga
authors.affiliation: Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takamochi
authors.affiliation: Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Shiaki
authors.initials: S
authors.lastname: Oh
authors.affiliation: Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords:  Segmentectomy; Locoregional recurrence; Lung carcinoma; Solid tumour