European experience on oncological outcomes of patients with early-stage non-small cell lung cancer and any prior cancer following lobectomy or segmentectomy

Objectives: To assess the impact of lung resection extent on early-stage non-small cell lung cancer with a history of any cancer. Methods: Retrospective multicentric cohort study including patients with ≤2 cm pathologic size lung cancer with a history of any cancer, operated on from 2015 to 2021 across nine European centers (one per country). Overall survival (OS), disease-free survival (DFS) and lung cancer specific death (LCSD) between both groups were assessed before and after propensity score (PS) −matching. Risk factors for oncologic outcomes were analyzed using parsimonious model cox proportional hazard regression. Kaplan Meier and cumulative incidence function assessed the outcomes. Log-rank test and Gray’ test compared the groups. Linearized risk was used to assess recurrences. Results: Of the 1910 patients with early-stage lung cancer patients, 540 (28.2%) had a prior cancer. Lobectomy and segmentectomy were performed in 409 (75.7%) and 131 (24.3%) patients respectively. 5-year OS rates: lobectomy 81.5%, segmentectomy 80.8%, p = 0.8; DFS: lobectomy 76.9%, segmentectomy 74.4%, p = 0.6 and LCSD: lobectomy 8.0%, segmentectomy 4.9%, p = 0.2. These finding were similar in the matched cohort. Locoregional recurrence (linearized risk: lobectomy 0.111, segmentectomy 0.066) and distant recurrence (linearized risk: lobectomy 0.093, segmentectomy 0.055) were not worse in the segmentectomy group. In multivariable analysis, prior cancer negatively impacted only lung cancer specific death HR:1.27 (95%CI:1.00–1.60). Conclusion: Compared to lobectomy, segmentectomy has not shown a worse oncologic outcome in patients with history of any prior cancer.