Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC
Objective: Besides the discussion on parenchymal margin, data on the extent of lymph node (LN) dissection are scarce, especially in segmentectomy. This study aimed to investigate the extent of LN dissection and detection of occult disease in segmentectomy compared with lobar resection. Methods: We p...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | JTO Clinical and Research Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364325000785 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850038621914005504 |
|---|---|
| author | Yota Suzuki, MD Rajeev Dhupar, MD Inderpal S. Sarkaria, MD, MBA Ian G. Christie, MD Summer N. Mazur, BS Arjun Pennathur, MD James D. Luketich, MD Ryan M. Levy, MD Rodney J. Landreneau, MD Matthew J. Schuchert, MD |
| author_facet | Yota Suzuki, MD Rajeev Dhupar, MD Inderpal S. Sarkaria, MD, MBA Ian G. Christie, MD Summer N. Mazur, BS Arjun Pennathur, MD James D. Luketich, MD Ryan M. Levy, MD Rodney J. Landreneau, MD Matthew J. Schuchert, MD |
| author_sort | Yota Suzuki, MD |
| collection | DOAJ |
| description | Objective: Besides the discussion on parenchymal margin, data on the extent of lymph node (LN) dissection are scarce, especially in segmentectomy. This study aimed to investigate the extent of LN dissection and detection of occult disease in segmentectomy compared with lobar resection. Methods: We performed a single-institution, retrospective analysis for patients who underwent segmentectomy or lobectomy for clinical T1N0M0 (≤3 cm) NSCLC from 2012 to 2022. The extent of LN dissection and the rate of detection of occult LN disease were compared. N1 nodes were further classified as collected as a specimen during the operation (N1 dissection) and the nodes retrieved from lung specimens by pathologists (N1 lung specimen). Results: During the study period, 957 lobectomies and 402 segmentectomies were performed for clinical T1N0M0 NSCLC. The median number of sampled LNs was significantly higher in the lobectomy group (18 versus 12; p < 0.001). This tendency was similar across all node groups, including N2 nodes (7 versus 5), N1 dissection nodes (6 versus 4), and most significantly N1 lung specimen nodes (4 versus 0; all p < 0.001) There was a significant difference in N1 occult nodes (13.3% versus 3.7%; p < 0.001), whereas the difference was not significant in N2 occult nodes (5.5% versus 3.2%; p = 0.074). Conclusions: Segmentectomy was associated with less LN sampling, which translated into lower detection of occult nodal metastasis in N1 LNs. Although standardized pathologic dissection could potentially improve detection, there is likely an inevitable inferiority in LN sampling with segmentectomy. |
| format | Article |
| id | doaj-art-6b4d51c5bce446b896a2063b5fa43545 |
| institution | DOAJ |
| issn | 2666-3643 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj-art-6b4d51c5bce446b896a2063b5fa435452025-08-20T02:56:32ZengElsevierJTO Clinical and Research Reports2666-36432025-08-016810086110.1016/j.jtocrr.2025.100861Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLCYota Suzuki, MD0Rajeev Dhupar, MD1Inderpal S. Sarkaria, MD, MBA2Ian G. Christie, MD3Summer N. Mazur, BS4Arjun Pennathur, MD5James D. Luketich, MD6Ryan M. Levy, MD7Rodney J. Landreneau, MD8Matthew J. Schuchert, MD9Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Corresponding author. Address for correspondence: Yota Suzuki, MD, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh 15213, Pennsylvania.Department of Cardiothoracic Surgery, Wake Forest University, Winston-Salem, North CarolinaDepartment of Cardiovascular & Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TexasDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PennsylvaniaDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PennsylvaniaDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PennsylvaniaDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PennsylvaniaDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PennsylvaniaTampa General Hospital, Tampa, FloridaDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PennsylvaniaObjective: Besides the discussion on parenchymal margin, data on the extent of lymph node (LN) dissection are scarce, especially in segmentectomy. This study aimed to investigate the extent of LN dissection and detection of occult disease in segmentectomy compared with lobar resection. Methods: We performed a single-institution, retrospective analysis for patients who underwent segmentectomy or lobectomy for clinical T1N0M0 (≤3 cm) NSCLC from 2012 to 2022. The extent of LN dissection and the rate of detection of occult LN disease were compared. N1 nodes were further classified as collected as a specimen during the operation (N1 dissection) and the nodes retrieved from lung specimens by pathologists (N1 lung specimen). Results: During the study period, 957 lobectomies and 402 segmentectomies were performed for clinical T1N0M0 NSCLC. The median number of sampled LNs was significantly higher in the lobectomy group (18 versus 12; p < 0.001). This tendency was similar across all node groups, including N2 nodes (7 versus 5), N1 dissection nodes (6 versus 4), and most significantly N1 lung specimen nodes (4 versus 0; all p < 0.001) There was a significant difference in N1 occult nodes (13.3% versus 3.7%; p < 0.001), whereas the difference was not significant in N2 occult nodes (5.5% versus 3.2%; p = 0.074). Conclusions: Segmentectomy was associated with less LN sampling, which translated into lower detection of occult nodal metastasis in N1 LNs. Although standardized pathologic dissection could potentially improve detection, there is likely an inevitable inferiority in LN sampling with segmentectomy.http://www.sciencedirect.com/science/article/pii/S2666364325000785NSCLCSegmentectomyLymph node dissection |
| spellingShingle | Yota Suzuki, MD Rajeev Dhupar, MD Inderpal S. Sarkaria, MD, MBA Ian G. Christie, MD Summer N. Mazur, BS Arjun Pennathur, MD James D. Luketich, MD Ryan M. Levy, MD Rodney J. Landreneau, MD Matthew J. Schuchert, MD Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC JTO Clinical and Research Reports NSCLC Segmentectomy Lymph node dissection |
| title | Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC |
| title_full | Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC |
| title_fullStr | Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC |
| title_full_unstemmed | Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC |
| title_short | Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC |
| title_sort | occult node detection with lobectomy versus segmentectomy for stage ia nsclc |
| topic | NSCLC Segmentectomy Lymph node dissection |
| url | http://www.sciencedirect.com/science/article/pii/S2666364325000785 |
| work_keys_str_mv | AT yotasuzukimd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT rajeevdhuparmd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT inderpalssarkariamdmba occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT iangchristiemd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT summernmazurbs occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT arjunpennathurmd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT jamesdluketichmd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT ryanmlevymd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT rodneyjlandreneaumd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc AT matthewjschuchertmd occultnodedetectionwithlobectomyversussegmentectomyforstageiansclc |