Abstract 117P
Background
The aim of this study was to analyse the prognostic influence of tumour spread through air spaces (STAS) on thoracoscopic segmentectomy compared with lobectomy for clinical stage I non-small cell lung cancer (NSCLC).
Methods
Patients who underwent thoracoscopic segmentectomy or lobectomy for clinical stage I NSCLC from September 2020 through September 2023 at a high-volume thoracic unit. were included. Recurrence-free survival (RFS) and overall survival (OS) between the two procedures were assessed using Kaplan-Meier analysis with log-rank test. Cox regression model was used to analyse independent factors for survivals.
Results
STAS was available in 785 patients, including 151 (19.2%) patients with STAS and 634 (80.8%) patients without STAS. The STAS positive group had significantly higher vascular and lymphatic invasion. The median follow-up was 25.1 months (IQR 20.1-31.1). In the group without STAS, there were no survival difference between segmentectomy (n = 87) and lobectomy (n = 547) (3-year RFS: 77.4% vs 82.6%, p = .350; 3-year OS: 87.5% vs 95.3%, p = .190). Whereas worse survival was found in segmentectomy for patients with STAS (n = 16) compared to lobectomy (n = 135) (3-year RFS: 69.8% vs 82.7%, p < .001; 3-year OS: 58.4% vs 89.0%, p < .001). In multivariable analysis, segmentectomy was an independent prognostic factor for RFS in patients with STAS (HR 9.28, 95% CI 7.66 to 18.18), as well as pleural invasion (HR 5.25, 95% CI 1.44 to 19.16). Moreover, segmentectomy (HR 13.55, 95% CI 3.98 to 46.20) and older age (per 5-year increase: HR 1.96, 95% CI 1.11 to 3.48) were independent prognostic factors of OS among patients with STAS.
Conclusions
In this study there was a superior RFS and OS for lobectomy vs. segmentectomy for clinical stage I NSCLC with STAS.
Legal entity responsible for the study
The authors.
Funding
Rigshospitalet.
Disclosure
R.H. Petersen: Financial Interests, Personal, Invited Speaker: Medtronic, Medela, AstraZeneca and AMBU; Financial Interests, Personal, Advisory Board: AstraZeneca, MSD, BMS and Roche. L. Huang: Financial Interests, Personal, Funding: Rigshospitalet, Copenhagen University Hospital.