Asia expert consensus on segmentectomy in non–small cell lung cancer: A modified Delphi study

Lunxu Liu, Keiju Aokage, Chang Chen, Chun Chen, Liang Chen, Yong Hee Kim, Chang Young Lee, Chengwu Liu, Chia Chuan Liu, Wataru Nishio, Kenji Suzuki, Lijie Tan, Yau Lin Tseng, Masaya Yotsukura, Shun ichi Watanabe

研究成果: Article同行評審

摘要

Objective: Segmentectomy as a parenchymal-sparing surgical approach has been recommended over lobectomy in select patients with early-stage non–small cell lung cancer. This study aimed to address 3 aspects of segmentectomy (“patient indication”; “segmentectomy approaches”; “lymph node assessment”) where there is limited clinical guidance. Methods: A modified Delphi approach comprising 3 anonymous surveys and 2 expert discussions was used to establish consensus on the aforementioned topics among 15 thoracic surgeons (2 Steering Committee; 2 Task Force; 11 Voting Experts) from Asia who have extensive segmentectomy experience. Statements were developed by the Steering Committee and Task Force based on their clinical experience, published literature (rounds 1-3), and comments received from Voting Experts through surveys (rounds 2-3). Voting Experts indicated their agreement with each statement on a 5-point Likert scale. Consensus was defined as ≥70% of Voting Experts selecting either “Agree”/“Strongly Agree” or “Disagree”/“Strongly Disagree.” Results: Consensus from the 11 Voting Experts was reached on 36 statements (11 “patient indication” statements; 19 “segmentation approaches” statements; 6 “lymph node assessment” statements). In rounds 1, 2, and 3, consensus was reached on 48%, 81%, and 100% of drafted statements, respectively. Conclusions: A recent phase 3 trial reported significantly improved 5-year overall survival rates for segmentectomy compared with lobectomy, proposing thoracic surgeons to consider segmentectomy as a surgical option in suitable patients. This consensus serves as a guidance to thoracic surgeons considering segmentectomy in patients with early non–small cell lung cancer, outlining key principles that surgeons should consider in surgical decision-making.

原文English
頁(從 - 到)483-501
頁數19
期刊JTCVS Open
14
DOIs
出版狀態Published - 2023 6月

All Science Journal Classification (ASJC) codes

  • 手術
  • 肺和呼吸系統醫學
  • 心臟病學與心血管醫學

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