Segmentectomy Versus Lobectomy in NSCLC With Pathologically Invasive Features: A Post Hoc Supplementary Analysis of Multicenter, Phase 3 Trial JCOG0802/WJOG4607L.

However, its advantages compared with lobectomy in NSCLC harboring pathologically invasive features remain unclear.

然而，与肺叶切除术相比，对于具有病理侵袭特征的NSCLC，其优势仍不清楚。

Methods

We conducted a post hoc supplementary analysis of randomized controlled phase 3 trial JCOG0802/WJOG4607L in patients with clinical stage IA NSCLC (≤2 cm) harboring one or more of the following pathologically invasive features: lymphatic, vascular, or pleural invasion and lymph node metastasis.

我们在临床阶段IA NSCLC（≤2 cm）患者中进行了JCOG0802/WJOG4607L随机对照III期试验的事后补充分析，这些患者具有一种或多种以下病理侵袭特征：淋巴、血管或胸膜侵犯以及淋巴结转移。

The primary outcome was overall survival(OS), and secondary outcomes were relapse-free survival, cumulative incidenceof locoregional relapse, lung cancer-specific death, and death from other causes.

主要结果是总生存期（OS），次要结果包括无复发生存期、局部区域复发的累积发生率、肺癌特异性死亡和其它原因死亡。

Results

Of the 1106 participants randomly assigned to the lobectomy or segmentectomy arm, 298 (27%) were included in this analysis: 164 patients were in the lobectomy arm and 134 in the segmentectomy arm.

在随机分配到肺叶切除术或肺段切除术组的1106名参与者中，有298名（27%）被纳入本分析：肺叶切除术组有164名患者，肺段切除术组有134名。

At a median follow-up of 7.1 (interquartile range: 5.9-8.4) years, segmentectomy demonstrated a trend toward better OS than lobectomy, with hazard ratio(HR) of 0.657 (95% confidence interval[CI]: 0.401-1.077; p = 0.0936).

在中位随访7.1年（四分位数范围：5.9-8.4年）时，肺段切除术显示出比肺叶切除术更好的总生存期趋势，风险比（HR）为0.657（95%置信区间[CI]：0.401-1.077；p = 0.0936）。

The cumulative incidenceof death from other causes was significantly reduced in the segmentectomy arm compared with the lobectomy arm (HR = 0.359 [95% CI: 0.143-0.900]).

与肺叶切除术组相比，肺段切除术组的其他原因死亡的累积发生率显著降低（HR = 0.359 [95% CI: 0.143-0.900]）。

Relapse-free survival and cumulative incidenceof lung cancer-specific death were not significantly different between the two arms, whereas the cumulative incidenceof locoregional relapse was significantly higher in the segmentectomy than in the lobectomy arm (HR = 2.234 [95% CI: 1.334-3.741]).

两组之间的无复发生存期和肺癌特异性死亡的累积发生率没有显著差异，而肺段切除术组的局部区域复发的累积发生率显著高于肺叶切除术组（HR = 2.234 [95% CI: 1.334-3.741]）。

Conclusions

Segmentectomy demonstrated better OS compared with lobectomy even for NSCLC harboring pathologically invasive features.

即使对于具有病理侵袭特征的非小细胞肺癌（NSCLC），段切除术显示出比肺叶切除术更好的总体生存率（OS）。

However, the risk of locoregional relapse after segmentectomy should be considered.

然而，进行段切除术后，应考虑局部复发的风险。