P-154SPLIT-LOBE RESECTIONS VERSUS LOBECTOMY FOR LUNG CARCINOMA OF THE LEFT UPPER LOBE: A PAIR-MATCHED CASE-CONTOL STUDY

• Published in: Interactive cardiovascular and thoracic surgery 2013-07, Vol.17 (suppl_1), p.S40-S41
• Main Authors: Witte, Biruta, Wolf, M., Hillebrand, H., Huertgen, M.
• Format: Article
• Language: English
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivt288.154

Objectives Segmentectomy is indicated for peripheral small lung carcinoma up to 2 cm diameter confined to one segment, and/or in patients unable to tolerate a lobectomy. The left upper lobe can be divided easily into an upper (segments 1-3) and lingular (segments 4 and 5) segmental group, facillitating sublobar resections that are probably appropriate for tumours of larger diameters and unfavourable localisation. Methods This study compares 22 consecutive split-lobe resections to 44 pair-matched left upper lobectomy controls with regard to clinical and oncolgical outcome. Results Split-lobe and lobectomy groups had equal tumour diameters (22.5 (11-63) mm vs 25 (7-68) mm) and identical pN stages (pN0 77.3%, pN1 9.1%, pN2 9.1%, ypN0 4.5%), a similar clinical course despite lower pre-OP FEV1 and higher comorbidity in the split-lobe group, and similar long-term overall (0.904 vs 0.821 at 5 years) and disease-free survival (0.854 vs 0.609 at 5 years). Conclusions Left upper lobectomy might be an overtreatment for lung carcinoma resectable by split-lobe procedures. Larger confirmatory studies are neccessary. Disclosure M. Huertgen: consultant for Karl Storz GmbH Storz, Tuttlingen, Germany and for Richard Wolf GmbH, Knittlingen, Germany. All other authors have declared no conflicts of interest.