About this trial
This study aims to evaluate the non-inferiority in recurrence-free survival and overall survival of segmentectomy compared with lobectomy in patients with lung adenocarcinoma ≤ 2 cm with micropapillary and solid subtype negative by intraoperative frozen sections.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Patient aged 20-79 years old, both male or female;
Tumor size <= 2cm on preoperative CT scan;
Peripheral solitary nodule or the associated lesion is MIA or less invasive lesion;
Preoperative CT indicated that the nodules were non-pure glass nodules (consolidation to tumor ratio >= 0.25);
Disqualifiers
Radiological pure ground glass nodules (consolidation to tumor ratio < 0.25);
The nodule is close to the lung hilus and is unable to perform segmentectomy;
Intraoperative frozen section confirmed with micropapillary and solid subtype positive (> 5%);
Intraoperative frozen section confirmed adenocarcinoma in situ and minimally invasive adenocarcinoma;
Trial design
Parallel
Treatments tested in this trial
Segmentectomy
Procedure/SurgerySegmentectomy with hilar and mediastinal lymph node dissection is performed. If the tumor located at inter-segment plane and without sufficient resection margin distance, a combined segmentectomy will be performed. Systemic or selective lymph node dissection is mandatory, and nodal sampling is not allowed. At least three stations of mediastinal lymph node from 2R, 4R, 7, 8, 9 for the right side and 5, 6, 7, 8, 9 for the left side, respectively. The distance from the dissection margin to the tumor edge must be evaluated intra-operatively. If the distance is either less than the maximum tumor diameter or 20 mm, the absence of cancer cells in the resection margin must be histologically or cytologically confirmed before finishing surgery.
Lobectomy
Procedure/SurgeryLobectomy with hilar and mediastinal lymph node dissection is performed. Segmentectomy with hilar and mediastinal lymph node dissection is performed. Systemic or selective lymph node dissection is mandatory, and nodal sampling is not allowed. At least three stations of mediastinal lymph node from 2R, 4R, 7, 8, 9 for the right side and 5, 6, 7, 8, 9 for the left side, respectively. The distance from the dissection margin to the tumor edge must be evaluated intra-operatively. If the distance is either less than the maximum tumor diameter or 20 mm, the absence of cancer cells in the resection margin must be histologically or cytologically confirmed before finishing surgery.
Treatment groups
Trial outcomes
Primary outcomes
recurrence-free survival rate
Recurrence-free survival (RFS) was defined as the time from surgery until recurrence or death from any cause
Secondary outcomes
overall survival
Overall survival (OS) was defined as the time from surgery until death from any cause
Post-operative respiratory function
The post-operative respiratory function will be evaluated by FEV1% and FVC.
Operation time
The surgery time in both groups.
Blood loss
Intraoperative blood loss in total.
Sponsors and contacts
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