P2.01-32 The Impact of Segmentectomy Versus Lobectomy on Pulmonary Function of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis

Abstract

Lobectomy with lymph node dissection is considered the standard surgical procedure for non-small cell lung cancer (NSCLC). Recently segmentectomy has been regarded as an alternative in early peripheral NSCLC owing to its theoretical advantages of lung function preservation. However, Segmentectomy presents some oncological risk. Thus, we performed a meta-analysis with the aim of evaluating whether segmentectomy offers an advantage in lung function preservation compared with lobectomy. We searched and retrieved studies from four databases. Postoperative results and lung functional index and were synthesized. The odds ratio (OR) or Standard Mean Difference (SMD) and its 95% CI were calculated using a random effects model. Subgroup division was conducted according to different time points. Single-arm meta-analysis for lung function of each visit time was conducted. Repeated-measures analysis of variance (ANOVA) was used to compare the lung function between each visit. A total of 16 eligible studies including 6,098 patients were recruited. Two groups showed no significant difference based on baseline characteristics before surgery between groups (Segmentectomy and Lobectomy). Segmentectomy correlated with a greater postoperative preserved pulmonary function than Lobectomy in FVC (SMD=0.23, p=0.009) and FEV1 (SMD=0.27, p=0.002), especially within 12 months after surgery. ANOVA showed no difference between FVC (p=0.647) and FEV1 (p=0.468) of the two groups according to visit time. The segmentectomy group showed no significant difference of postoperative complications compared with the Lobectomy groups (OR=0.95, p=0.618) and the recurrence rates were similar between groups (OR=0.90, p=0.644). Segmentectomy offers a better short-term but similar long-term lung functional preservation compared with Lobectomy, with similar surgical and oncological safety.