Impact of pathologically confirmed inner lung tumors on nodal upstaging and feasibility of segmentectomy versus lobectomy

Tane, Shinya; Shimizu, Nahoko; Jimbo, Naoe; Takanashi, Midori; Doi, Takefumi; Ogawa, Hiroyuki; Hokka, Daisuke; Kitamura, Yoshitaka; Shimomura, Yuki; Nishio, Wataru; Maniwa, Yoshimasa

https://hdl.handle.net/20.500.14094/0100501351

このアイテムのアクセス数:46件（2026-04-04 20:54 集計）

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メタデータID	0100501351
アクセス権	open access
出版タイプ	Version of Record
タイトル	Impact of pathologically confirmed inner lung tumors on nodal upstaging and feasibility of segmentectomy versus lobectomy
著者	Tane, Shinya ; Shimizu, Nahoko ; Jimbo, Naoe ; Takanashi, Midori ; Doi, Takefumi ; Ogawa, Hiroyuki ; Hokka, Daisuke ; Kitamura, Yoshitaka ; Shimomura, Yuki ; Nishio, Wataru ; Maniwa, Yoshimasa
著者ID A3225 研究者ID 1000010707160 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=98fd351ce98482cc520e17560c007669 著者名 Tane, Shinya 田根, 慎也タネ, シンヤ所属機関名医学部附属病院
著者名 Shimizu, Nahoko
著者ID A1546 研究者ID 1000000773772 ORCID 0000-0003-0423-3568 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=498438737e9a5984520e17560c007669 著者名 Jimbo, Naoe 神保, 直江ジンボ, ナオエ所属機関名医学部附属病院
著者名 Takanashi, Midori
著者ID A2086 研究者ID 1000070814490 著者名 Doi, Takefumi 土井, 健史ドイ, タケフミ所属機関名医学研究科
著者ID A1533 研究者ID 1000000727977 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=04850bfe3bfadf5a520e17560c007669 著者名 Ogawa, Hiroyuki 小川, 裕行オガワ, ヒロユキ所属機関名医学部附属病院
著者ID A1484 研究者ID 1000080715459 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=9a37cb0e45c284b2520e17560c007669 著者名 Hokka, Daisuke 法華, 大助ホッカ, ダイスケ所属機関名医学研究科
著者ID A3916 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=3b18d8d76d2409aa520e17560c007669 著者名 Kitamura, Yoshitaka 北村, 嘉隆キタムラ, ヨシタカ所属機関名医学部附属病院
著者ID A4039 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=aae02a82b7a7341d520e17560c007669 著者名 Shimomura, Yuki 下村, 由希シモムラ, ユキ所属機関名医学部附属病院
著者名 Nishio, Wataru
著者ID A0782 研究者ID 1000050362778 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=5a0f3a6ba5a3f888520e17560c007669 著者名 Maniwa, Yoshimasa 眞庭, 謙昌マニワ, ヨシマサ所属機関名医学部附属病院
言語	English (英語)
収録物名	JTCVS Open
巻(号)	29
ページ	101575
出版者	Elsevier
刊行日	2026-02
公開日	2026-02-24
抄録	Objectives: Previous studies reported worse outcomes for radiographically central tumors, but the impact of pathologically confirmed tumor origin remains unclear. This study investigated whether pathologically determined inner lesions are associated with nodal upstaging and poorer prognosis than outer lesions, and examined segmentectomy feasibility versus lobectomy. Methods: We retrospectively analyzed participants with clinical stage IA (Union for International Cancer Control version 8) non−small cell lung cancer who underwent segmentectomy and lobectomy between November 2007 and December 2022 at 2 Japanese centers. The location of the tumor origin was confirmed pathologically via the Walter classification. Tumors classified as central and intermediate were allocated to the inner group, whereas those classified as peripheral type were allocated to the outer group. The oncologic outcomes were compared between the 2 groups. After propensity score matching analysis on the basis of sex, age, pulmonary function, serum carcinoembryonic antigen level, and radiographic findings, we compared oncologic outcomes in patients who underwent segmentectomy (n = 99) and lobectomy (n = 99) in the inner group. Results: The cohort comprised inner (n = 654) and outer (n = 1275) groups. Nodal upstaging was greater in the inner group (13.1% [86/654] vs 9.5% [121/1275], P = .015). Five-year recurrence-free survival (RFS) was lower in the inner group (73.1%; 95% CI, 69.4%-77.3% vs 79.4%; 95% CI, 76.7%-81.8%, P = .002). Multivariable analysis did not identify segmentectomy as significant for RFS (hazard ratio, 0.81; 95% CI, 0.58-1.13; P = .20). In matched inner lesions, segmentectomy and lobectomy showed similar RFS (83.6%; 95% CI, 76.3-93.1% vs 76.4%; 95% CI, 66.8-87.4%; P = .80). Conclusions: Although worse prognosis and increased nodal upstaging should be considered in inner primary tumors, segmentectomy is an acceptable treatment option compared with lobectomy for pathologically confirmed inner-located early-stage NSCLC.
キーワード	inner lesion
	lung cancer
	prognosis
カテゴリ	医学研究科
	医学部附属病院
	学術雑誌論文
権利	© 2025 The Author(s). Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery.
権利	This is an open access article under the Creative Commons Attribution 4.0 International license
関連情報	DOI https://doi.org/10.1016/j.xjon.2025.101575

資源タイプ	journal article
eISSN	2666-2736　OPACで所蔵を検索　 CiNiiで学外所蔵を検索

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