Advances in lung cancer surgery: the role of segmentectomy in early–stage management

Figures & data

Table 1. Definition of the lobar and sublobar anatomical and non-anatomical procedures for lung cancer.

Procedure	Definition
Lobectomy	Anatomical procedure that necessitates the division of Lobar bronchus Lobar artery branches Lobar venous drainage
Segmentectomy	Anatomical procedure that necessitates the division of Segmental bronchus Segmental artery Segmental vein Parenchymal division in accordance with segmental blood supply
Wedge resection	Non-anatomical procedure that eliminates lesion with bordering margin of healthy lung tissue

Table 2. Demographics and clinical characteristics of the patients enrolled in the randomized controlled trials [4,5]; modified from [15].

Trial	JCOG0802 [5]	CALGB140503 [4]
Enrolled	1319	1080
Randomized	1106	697
Male/Female Ratio	1.1	0.7
Smoker	55.7%	91.0%
Never smoker	44.3%	9.0%
ECOG Performance Status 0	97.9%	73.6%
Resections Wedge Segmentectomy Lobectomy	1 544 533	201 129 357
Histological Types Adenocarcinoma Squamous Other	90.7% 6.8% 2.5%	63.7% 14.1% 22.2%
5-years Overall Survival Lobectomy Segmentectomy	94.3% 91.1%	80.3% 78.9%
5-year Disease-Free Survival Lobectomy Segmentectomy	87.9% 88.0%	63.6% 64.1%
Loco-regional Recurrence Lobectomy Segmentectomy	11.0 5.0	13.4 10.0

Altorki N, Wang X, Kozono D, et al. Lobar or sublobar resection for peripheral stage IA non-small-cell lung cancer. N Engl J Med. 2023 Feb 9;388(6):489–498. doi: 10.1056/NEJMoa2212083

 PubMed Web of Science ®Google Scholar

Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607–1617. doi: 10.1016/S0140-6736(21)02333-3

 PubMed Web of Science ®Google Scholar

Kocak Uzel E, Bagci Kilic M, Morcali H, et al. Stereotactic body radiation therapy for stage I medically operable non-small cell lung cancer. Sci Rep. 2023 Jun 27;13(1):10384.

 PubMed Web of Science ®Google Scholar