Oncologic outcomes of segmentectomy vs lobectomy in pathologic stage IA (≤2 cm) invasive lung adenocarcinoma: A population-based study.

BACKGROUND AND OBJECTIVES: For early-stage invasive lung adenocarcinoma, it remains unclear whether segmentectomy can yield outcomes equivalent to those of lobectomy. This study aimed to compare survival outcomes after segmentectomy and lobectomy among patients with stage IA invasive lung adenocarcinoma. METHODS: We identified patients with stage IA (≤2 cm) invasive lung adenocarcinoma who underwent segmentectomy or lobectomy from the Surveillance, Epidemiology, and End Results database (2004-2015). Propensity score matching (PSM) was used to balance the baseline characteristics. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared using the Kaplan-Meier method and Cox proportional hazards regression. RESULTS: A total of 5474 patients were included. Before PSM, the 5-year OS was 78.3% for patients undergoing lobectomy vs 76.5% for patients undergoing segmentectomy (P = .166) while LCSS were 86.8% vs 83.0% (P = .015). After PSM, survival analyses showed that segmentectomy had OS (75.8% vs 76.4%; P = .694) and LCSS (82.7% vs 82.9%; P = .604) equivalent to those of lobectomy. Cox regression demonstrated that segmentectomy was equivalent to lobectomy in terms of OS and LCSS before and after PSM. CONCLUSION: For stage IA (≤2 cm) invasive lung adenocarcinoma, segmentectomy may have oncologic outcomes equivalent to those of lobectomy.