Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: A propensity score matching study from the Italian VATS Group Registry

Dell'Amore, A.; Lomangino, I.; Cannone, G.; Terzi, S.; Pangoni, A.; Lorenzoni, G.; Nicotra, S.; Schiavon, M.; Zuin, A.; Gregori, D.; Crisci, R.; Curcio, C.; Rea, F.; Mancuso, M.; Pernazza, F.; Refai, M.; Bortolotti, L.; Rizzardi, G.; Solli, P.; Brandolini, I.; Perkmann, R.; Zaraca, F.; Benvenuti, M.; Gavezzoli, D.; Cherchi, R.; Ferrari, P.; Mucilli, F.; Camplese, P.; Melloni, G.; Mazza, F.; Cavallesco, G.; Maniscalco, P.; Voltolini, L.; Gonfiotti, A.; Stella, F.; Argnani, D.; Pariscenti, G. L.; Iurilli, S.; Surrente, C.; Lopez, C.; Droghett, A.; Giovanardi, M.; Breda, C.; Lo Giudice, F.; Alloisio, M.; Bottoni, E.; Spaggiari, L.; Gasparri, R.; Torre, M.; Rinaldo, A.; Nosotti, M.; Rosso, L.; Negri, G. P.; Bandiera, A.; Stefani, A.; Natali, P.; Scarci, M.; Pirondini, E.; Curcio, C.; Amore, D.; Baietto, G.; Casadio, C.; Bertani, A.; Russo, E.; Ampollini, L.; Carbognani, P.; Puma, F.; Vinci, D.; Andreetti, C.; Poggi, C.; Cardillo, G.; Margaritora, S.; Meacci, E.; Luzzi, L.; Ghisalberti, M.; Crisci, R.; Zaccagna, G.; Lausi, P.; Guerrera, F.; Fontana, D.; Della Beffa, V.; Morelli, A.; Londero, F.; Imperatori, N.; Rotolo, A.; Terzi, A.; Viti, A.; Infante, M.; Benato, C.

doi:10.1093/ejcts/ezab430

OBJECTIVES: Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS: We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS: The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS: Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: A propensity score matching study from the Italian VATS Group Registry / Dell'Amore A.; Lomangino I.; Cannone G.; Terzi S.; Pangoni A.; Lorenzoni G.; Nicotra S.; Schiavon M.; Zuin A.; Gregori D.; Crisci R.; Curcio C.; Rea F.; Mancuso M.; Pernazza F.; Refai M.; Bortolotti L.; Rizzardi G.; Solli P.; Brandolini I.; Perkmann R.; Zaraca F.; Benvenuti M.; Gavezzoli D.; Cherchi R.; Ferrari P.; Mucilli F.; Camplese P.; Melloni G.; Mazza F.; Cavallesco G.; Maniscalco P.; Voltolini L.; Gonfiotti A.; Stella F.; Argnani D.; Pariscenti G.L.; Iurilli S.; Surrente C.; Lopez C.; Droghett A.; Giovanardi M.; Breda C.; Lo Giudice F.; Alloisio M.; Bottoni E.; Spaggiari L.; Gasparri R.; Torre M.; Rinaldo A.; Nosotti M.; Rosso L.; Negri G.P.; Bandiera A.; Stefani A.; Natali P.; Scarci M.; Pirondini E.; Curcio C.; Amore D.; Baietto G.; Casadio C.; Bertani A.; Russo E.; Ampollini L.; Carbognani P.; Puma F.; Vinci D.; Andreetti C.; Poggi C.; Cardillo G.; Margaritora S.; Meacci E.; Luzzi L.; Ghisalberti M.; Crisci R.; Zaccagna G.; Lausi P.; Guerrera F.; Fontana D.; Della Beffa V.; Morelli A.; Londero F.; Imperatori N.; Rotolo A.; Terzi A.; Viti A.; Infante M.; Benato C.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - ELETTRONICO. - 61:(2022), pp. 533-542. [10.1093/ejcts/ezab430]