AI Article Synopsis
- The study aims to compare how well segmentectomy preserves lung function compared to lobectomy in patients with early-stage non-small cell lung cancer and emphysema.
- Between 2000 and 2006, researchers analyzed postoperative lung function changes in two groups: one undergoing lobectomy and the other segmentectomy.
- The findings suggest that segmentectomy is beneficial for patients with better lung function (above 80% of predicted FEV1), while those with more compromised function (below 70% FEV1) see no functional advantage over lobectomy.
Article Abstract
Objectives: To evaluate whether functional preservation after segmentectomy has a greater advantage of pulmonary functions than volume-reduction effects after lobectomy in patients with emphysema with clinical T1N0 non-small cell lung cancer (NSCLC).
Patients And Methods: Between January 2000 and December 2006, 47 cases of lobectomy and 71 cases of segmentectomy were performed in patients with stage I NSCLC using intraoperative sentinel node identification. The postoperative change of the forced expiratory volume in 1 second (deltaFEV(1)) 6 months after segmentectomy was compared with that of 6 months after lobectomy. The difference in the deltaFEV(1) between after segmentectomy and after lobectomy was evaluated according to the ratio of the estimated postoperative FEV(1) to the predicted normal value of FEV(1) (%ppoFEV(1)).
Results: In 50 patients with the preoperative FEV(1)% less than 70%, there was no difference in the deltaFEV(1) between the segmentectomy group (n = 30) and the lobectomy group (n = 20). In 36 patients with emphysema diagnosed by high-resolution chest computed tomography, a negative linear correlation between the %ppoFEV(1) and the deltaFEV(1) was found in the lobectomy subgroup (n = 16, r = 0.508, p = 0.0012), but not in the segmentectomy subgroup (n = 20). When patients with emphysema had the %ppoFEV(1) more than or equal to 70%, the deltaFEV(1) had a tendency to be smaller in the segmentectomy subgroups than in the lobectomy subgroups.
Conclusion: Segmentectomy should be considered in patients with cT1N0 NSCLC with a normal (>80%) predicted postoperative FEV(1). In patients with a %ppoFEV(1) under 70%, segmentectomy offers no functional advantages over lobectomy.
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