Anatomic resection has superior long-term survival compared with wedge resection for second primary lung cancer after prior lobectomy

• Published in: European journal of cardio-thoracic surgery 2021-05, Vol.59 (5), p.1014-1020
• Main Authors: Baig, Mirza Zain, Razi, Syed S, Stroever, Stephanie, Weber, Joanna F, Connery, Cliff P, Bhora, Faiz Y
• Format: Article
• Language: English
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezaa443

Abstract   OBJECTIVES The extent of surgical resection for early-stage second primary lung cancer (SPLC) in patients with a previous lobectomy is unclear. We sought to compare anatomic lung resections (lobectomy and segmentectomy) and wedge resections for small peripheral SPLC using a population-based database. METHODS The Surveillance, Epidemiology and End Results database was queried for all patients with ≤2 cm peripheral SPLC diagnosed between 2004 and 2015 who underwent prior lobectomy for the first primary and surgical resection only for the SPLC. American College of Chest Physicians guidelines were used to classify SPLC. Kaplan–Meier analysis and multivariable Cox regression were used to compare overall survival. RESULTS A total of 356 patients met the inclusion criteria with 203 (57%) treated with wedge resection and 153 (43%) treated with anatomic resection. Significantly better median survival was observed with anatomic resection than with wedge resection using a Kaplan–Meier analysis (124 vs 63 months; P