Risk Factors for Recurrence of Non-Small-Cell Lung Cancer After Anatomical Segmentectomy.

[OBJECTIVES] This study aimed to identify prognostic factors associated with recurrence after anatomical segmentectomy in patients with clinical stage IA1 and IA2 non-small-cell lung cancer (NSCLC).

[METHODS] All patients who underwent anatomical segmentectomy for clinical stage IA1 and IA2 NSCLC between January 2018 and January 2020 were included. Recurrence was histologically confirmed, with recurrent tumors presenting histopathological features identical to the primary lung cancer. Baseline clinical and pathological characteristics of patients with and without recurrence were compared using inferential statistical methods. Kaplan-Meier and Cox regression analyses evaluated significant predictors of recurrence over time.

[RESULTS] A total of 180 patients were retrospectively analyzed (mean age 70.4 ± 7.5 years; 63.9% males; mean follow-up 3.1 ± 0.9 years). Recurrence occurred in 18 patients (10%). Logistic regression analysis indicated that recurrence was 5.1 times more prevalent in patients with tumor size ≥ 1.5 cm than in those with tumor size  < 1.5 cm (odds ratio [OR] 5.1; 95% confidence interval [CI] 1.4-18.4, p = 0.01) and 2.9 times more prevalent in patients with pathological upstaging than in those without (OR 2.9; 95% CI 1.0-8.2, p = 0.04). Kaplan-Meier analysis revealed significant differences in recurrence-free estimates between patients with solid tumors ≥ 1.5 cm and those < 1.5 cm (p < 0.01) and between those with and without pathological upstaging (p = 0.05).

[CONCLUSIONS] Recurrence after anatomical segmentectomy for stage IA1 and IA2 NSCLC is significantly influenced by tumor size and pathological upstaging, underscoring the importance of tailored surgical strategies and meticulous pathological assessment to optimize long-term outcomes and reduce recurrence risk.