Comparison of 5-Year Survival and Disease Recurrence After Trisegmentectomy or Left Upper Lobectomy: A Propensity Score Analysis of the National GEVATS Database
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Borja Aguinagalde [3] ; Juan A. Ferrer Bonsoms [1] ; Iker López [3] ; Ion Ander Lizarbe [3] ; Arantza Fernández Monge [3] ; José Luis Recuero [2] ; Iñigo Royo [2] ; Raúl Embún [2]
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[1] Universidad de Navarra
Universidad de Navarra
Pamplona, España
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[2] Hospital Miguel Servet
Hospital Miguel Servet
Zaragoza, España
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[3] Osakidetza Basque Health Service, Donostia University Hospital, Department of Thoracic Surgery, Donostia, Spain
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- Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 60, Nº. 11, 2024, págs. 705-713
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
Introduction Trisegmentectomy, or resection of the upper subdivision of the left upper lobe with preservation of the lingula, is considered by some authors to be equivalent to right upper lobectomy with middle lobe preservation.
Our objective was to compare survival and recurrence after trisegmentectomy versus left upper lobectomy procedures registered in the Spanish Video-Assisted Thoracic Surgery group (GEVATS) database.
Methods We compared mortality, survival and recurrence in patients with left upper lobectomy or trisegmentectomy after propensity score matching for the following variables: age, smoking habit, tumor size, histologic type, radiological density of tumor, surgical access, forced expiratory volume in one second, diffusing capacity of the lungs for carbon monoxide, hypertension, chronic heart failure, ischemic heart disease, arrhythmia, stroke, peripheral vascular disease, diabetes and pre-surgery nodal status by positron emission tomography/computed tomography.
Results A total of 540 left upper lobectomies and 83 trisegmentectomies were registered in the GEVATS database. After propensity score matching, 134 left upper lobectomies and 67 trisegmentectomies were selected. Survival outcomes were similar, but differences were found for recurrence (21.5% for trisegmentectomies vs. 35.4% for left upper lobectomies, p=0.05). Moreover, the recurrence patterns differed, with the lobectomy group showing a greater tendency to distant dissemination.
Conclusions Trisegmentectomy and left upper lobectomy show similar 5-year survival rates. In our database, recurrence after trisegmentectomy was lower than after left upper lobectomy, while the recurrence pattern differed among the 2 surgical approaches, with a greater tendency to distant metastasis after left upper lobectomy.
