Outcomes of sublobar resection vs lobectomy for invasive clinical stage T1N0 non-small-cell lung cancer: A propensity-match analysis.
Aged
Carcinoma, Non-Small-Cell Lung
/ diagnosis
Disease-Free Survival
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Lung
/ pathology
Lung Neoplasms
/ diagnosis
Male
Middle Aged
Neoplasm Recurrence, Local
/ epidemiology
Neoplasm Staging
Pneumonectomy
/ methods
Propensity Score
Prospective Studies
Retrospective Studies
Survival Rate
NSCLC
lobectomy
sub-lobar resection
Journal
Cancer reports (Hoboken, N.J.)
ISSN: 2573-8348
Titre abrégé: Cancer Rep (Hoboken)
Pays: United States
ID NLM: 101747728
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
22
12
2020
received:
19
10
2020
accepted:
05
01
2021
pubmed:
12
2
2021
medline:
4
1
2022
entrez:
11
2
2021
Statut:
ppublish
Résumé
The role of sub lobar resection (SLR; either segmentectomy or wedge resection) vs lobectomy (LBCT) for invasive clinical stage T1N0 non-small-cell-lung-cancer (NSCLC) has not been fully established yet. We aimed to characterize the preoperative parameters leading to selecting SLR and compare the overall survival (OS) and disease-free survival (DFS) of these two surgical approaches. Clinical data on 162 patients (LBCT-107; SLR-55) were prospectively entered in our departmental database. Preoperative parameters associated with the performance of SLR were identified using univariate and multivariate cox regression analysis. The Kaplan-Meier method was used to compute OS and DFS. Comparison between LBCT and SLR groups and 32 propensity-matched groups was performed using Log-rank test. Median follow-up time for the LBCT and SLR groups was 4.76 (Inter-quartile range [IQR] 2.96 to 8.23) and 3.38 (IQR 2.9 to 6.19) years respectively. OS and DFS rates were similar between the two groups in the entire cohort (OS-LBCT vs SLR P = .853, DSF-LBCT vs SLR P = .653) and after propensity matching (OS-LBCT vs SLR P = .563 DSF-LBCT vs SLR P = .632). Specifically, Two- and five-year OS rates for LBCT and SLR were 90.6.% vs 92.7%, 71.8% vs 75.9% respectively. Independent predictors of selecting for SLR included older age (P < .001), reduced FEV1% (P = .026), smaller tumor size (P = .025), smaller invasive component (P = .021) and higher American Society of Anesthesiology scores (P = .014). In 162 consecutive and 32 matched cases, SLR and lobar resection had similar overall and disease-free survival rates. SLR may be considered as a reasonable oncological procedure in carefully selected T1N0 NSCLC patients that present with multiple comorbidities and relatively small tumors.
Sections du résumé
BACKGROUND
The role of sub lobar resection (SLR; either segmentectomy or wedge resection) vs lobectomy (LBCT) for invasive clinical stage T1N0 non-small-cell-lung-cancer (NSCLC) has not been fully established yet.
AIM
We aimed to characterize the preoperative parameters leading to selecting SLR and compare the overall survival (OS) and disease-free survival (DFS) of these two surgical approaches.
METHODS
Clinical data on 162 patients (LBCT-107; SLR-55) were prospectively entered in our departmental database. Preoperative parameters associated with the performance of SLR were identified using univariate and multivariate cox regression analysis. The Kaplan-Meier method was used to compute OS and DFS. Comparison between LBCT and SLR groups and 32 propensity-matched groups was performed using Log-rank test.
RESULTS
Median follow-up time for the LBCT and SLR groups was 4.76 (Inter-quartile range [IQR] 2.96 to 8.23) and 3.38 (IQR 2.9 to 6.19) years respectively. OS and DFS rates were similar between the two groups in the entire cohort (OS-LBCT vs SLR P = .853, DSF-LBCT vs SLR P = .653) and after propensity matching (OS-LBCT vs SLR P = .563 DSF-LBCT vs SLR P = .632). Specifically, Two- and five-year OS rates for LBCT and SLR were 90.6.% vs 92.7%, 71.8% vs 75.9% respectively. Independent predictors of selecting for SLR included older age (P < .001), reduced FEV1% (P = .026), smaller tumor size (P = .025), smaller invasive component (P = .021) and higher American Society of Anesthesiology scores (P = .014).
CONCLUSIONS
In 162 consecutive and 32 matched cases, SLR and lobar resection had similar overall and disease-free survival rates. SLR may be considered as a reasonable oncological procedure in carefully selected T1N0 NSCLC patients that present with multiple comorbidities and relatively small tumors.
Identifiants
pubmed: 33570255
doi: 10.1002/cnr2.1339
pmc: PMC8222555
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1339Informations de copyright
© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.
Références
Eur J Cardiothorac Surg. 2019 Nov 1;56(5):858-866
pubmed: 31168591
J Thorac Oncol. 2011 Apr;6(4):751-6
pubmed: 21325976
Korean J Thorac Cardiovasc Surg. 2018 Dec;51(6):376-383
pubmed: 30588445
Jpn J Clin Oncol. 2010 Mar;40(3):271-4
pubmed: 19933688
Cancer Rep (Hoboken). 2021 Jun;4(3):e1339
pubmed: 33570255
CA Cancer J Clin. 2020 Jan;70(1):7-30
pubmed: 31912902
Lancet Respir Med. 2018 Dec;6(12):915-924
pubmed: 30442588
J Thorac Cardiovasc Surg. 2013 Jul;146(1):24-30
pubmed: 23398645
J Formos Med Assoc. 2017 Dec;116(12):917-923
pubmed: 28781098
J Thorac Oncol. 2018 Jun;13(6):767-778
pubmed: 29654928
J Thorac Dis. 2020 May;12(5):2049-2060
pubmed: 32642107
J Thorac Dis. 2020 Jun;12(6):3357-3362
pubmed: 32642260
J Thorac Cardiovasc Surg. 2020 Nov;160(5):1350-1357.e11
pubmed: 32033815
J Surg Res. 2019 Nov;243:371-379
pubmed: 31277014
Chest. 2021 Jan;159(1):390-400
pubmed: 32652096
J Clin Oncol. 2014 Aug 10;32(23):2449-55
pubmed: 24982447
J Thorac Cardiovasc Surg. 2019 Jun;157(6):2454-2465.e1
pubmed: 30954298
Thorac Cancer. 2020 Apr;11(4):907-917
pubmed: 32037690
J Thorac Cardiovasc Surg. 2019 Sep;158(3):895-907
pubmed: 31078312
Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3
pubmed: 7677489