155P - Survival after wedge resection, segmentectomy and lobectomy for clinical stage IA non-small cell lung cancer: A network meta-analysis and systematic review

Background

Surgical resection remains the cornerstone of early-stage treatment for non-small cell lung cancer (NSCLC). However, the survival benefits of different surgical methods in clinical stage IA patients remain controversial. This systematic review aims to compare the efficacy of surgical methods—lobectomy, segmentectomy, and wedge resection— on survival outcomes in clinical stage IA non-small cell lung cancer (NSCLC) patients.

Methods

A systematic search was performed in PubMed and other databases between January 2000 and November 30, 2024. Studies meeting the inclusion and exclusion criteria were identified, and overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) data from each study were extracted for pairwise and Bayesian network meta-analyses.

Results

For patients with overall stage IA, network meta-analyses showed that both lobectomy and segmentectomy had significant advantages in OS, DFS, and RFS compared to wedge resection (HR_OS 0.67 [0.59–0.75], 0.75 [0.65–0.84]; HR_DFS 0.69 [0.54–0.89], 0.71 [0.55–0.92]; HR_RFS 0.57 [0.42–0.78], 0.53 [0.39–0.72]). No significant differences were observed between lobectomy and segmentectomy. Based on ranking probabilities, lobectomy ranked first. In subgroup analyses, results for T1a/b patients were consistent with those of stage IA. When 0.5 < Consolidation tumor ratio (CTR)

Conclusions

Lobectomy and segmentectomy provide better overall survival benefits compared to wedge resection in stage IA NSCLC patients, with no significant differences between lobectomy and segmentectomy. However, the optimal surgical approach should still be determined based on tumor size and CTR.

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.