Chengyu Bian, Chenghao Fu, Wentao Xue, Yan Gu, Hongchang Wang, Wenhao Zhang, Guang Mu, Mei Yuan, Liang Chen, Qianyun Wang, Jun Wang
{"title":"Anatomic and clinical implications of venous drainage variations in superior segment resections for clinical T1N0 non-small cell lung cancer.","authors":"Chengyu Bian, Chenghao Fu, Wentao Xue, Yan Gu, Hongchang Wang, Wenhao Zhang, Guang Mu, Mei Yuan, Liang Chen, Qianyun Wang, Jun Wang","doi":"10.21037/tlcr-24-807","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Superior segmentectomies for clinical T1N0 non-small cell lung cancer (NSCLC) often suffer from inadequate surgical margins. Our study aimed to enhance the precision of superior segmentectomies by focusing on the anatomical features of the superior segmental vein (V<sup>6</sup>) branches, and assess the relevant outcomes.</p><p><strong>Methods: </strong>The clinical data of 646 patients with cT1N0 NSCLC who underwent video-assisted thoracic surgery (VATS) from August 2020 to August 2021 were retrospectively analyzed. A total of 521 patients were enrolled for analyzing the prevalence and drainage patterns of V<sup>6</sup>b utilizing three-dimensional reconstruction images. Then, 162 patients who underwent segmentectomy were included to analyze the outcomes of superior segmentectomy. Disease-free survival (DFS) was estimated using the Kaplan-Meier method and compared across groups with the log-rank test.</p><p><strong>Results: </strong>The prevalence of V<sup>6</sup>b2 (a type of intersegmental vein between S<sup>6</sup> and S<sup>9</sup>) and V<sup>6</sup>b3 (between S<sup>6</sup> and S<sup>8</sup>) were 91.2% (475/521) and 66.2% (345/521), respectively, both primarily converging with other branches of V<sup>6</sup>. The segmentectomy groups showed no significant differences in surgical margins, tumor size, or other malignancy-related factors, such as TNM stage. Correspondingly, during a median follow-up of 3.23 years [interquartile range (IQR), 2.99-3.61 years], the patients who underwent superior segment (S<sup>6</sup>) resection achieved an overall survival (OS) rate of 100% (68/68) and a DFS rate of 97.1% (66/68), demonstrating outcomes comparable to other segmentectomies (P>0.05).</p><p><strong>Conclusions: </strong>High prevalence of V<sup>6</sup>b2 and V<sup>6</sup>b3 was observed with minimal variation in drainage patterns. Emphasizing these veins to ensure sufficient margins and potentially reducing aggressiveness through early detection, the outcomes of superior segmentectomies in this study are comparable to other segmentectomies and superior to those reported in previous studies.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"13 12","pages":"3256-3266"},"PeriodicalIF":4.0000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736576/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational lung cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tlcr-24-807","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/27 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Superior segmentectomies for clinical T1N0 non-small cell lung cancer (NSCLC) often suffer from inadequate surgical margins. Our study aimed to enhance the precision of superior segmentectomies by focusing on the anatomical features of the superior segmental vein (V6) branches, and assess the relevant outcomes.
Methods: The clinical data of 646 patients with cT1N0 NSCLC who underwent video-assisted thoracic surgery (VATS) from August 2020 to August 2021 were retrospectively analyzed. A total of 521 patients were enrolled for analyzing the prevalence and drainage patterns of V6b utilizing three-dimensional reconstruction images. Then, 162 patients who underwent segmentectomy were included to analyze the outcomes of superior segmentectomy. Disease-free survival (DFS) was estimated using the Kaplan-Meier method and compared across groups with the log-rank test.
Results: The prevalence of V6b2 (a type of intersegmental vein between S6 and S9) and V6b3 (between S6 and S8) were 91.2% (475/521) and 66.2% (345/521), respectively, both primarily converging with other branches of V6. The segmentectomy groups showed no significant differences in surgical margins, tumor size, or other malignancy-related factors, such as TNM stage. Correspondingly, during a median follow-up of 3.23 years [interquartile range (IQR), 2.99-3.61 years], the patients who underwent superior segment (S6) resection achieved an overall survival (OS) rate of 100% (68/68) and a DFS rate of 97.1% (66/68), demonstrating outcomes comparable to other segmentectomies (P>0.05).
Conclusions: High prevalence of V6b2 and V6b3 was observed with minimal variation in drainage patterns. Emphasizing these veins to ensure sufficient margins and potentially reducing aggressiveness through early detection, the outcomes of superior segmentectomies in this study are comparable to other segmentectomies and superior to those reported in previous studies.
期刊介绍：
Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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