A Multicenter Retrospective Case-Control Study on Simple versus Extended Sleeve Lobectomies.
Bronchoplasty
Extended sleeve
Lobectomy
Lung cancer
Sleeve
Journal
The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R
Informations de publication
Date de publication:
19 Jan 2024
19 Jan 2024
Historique:
received:
22
09
2023
revised:
30
11
2023
accepted:
03
01
2024
medline:
22
1
2024
pubmed:
22
1
2024
entrez:
21
1
2024
Statut:
aheadofprint
Résumé
Sleeve resection is currently the gold standard procedure for centrally located non-small cell lung cancer (NSCLC). Extended sleeve lobectomies(ESL) consist in an atypical bronchoplasty with resection of more than one lobe, and carry several technical difficulties compared to simple sleeve lobectomy(SSL). Our study aimed to compare the outcomes of ESL and SSL for NSCLC. This multicenter, retrospective, cohort study included 1314 patients who underwent ESL (155 patients) or SSL (1159 patients) between 2000 and 2018. The primary endpoints were: 30-day and 90-day mortality; overall survival(OS); Disease recurrence(DFS); complications. No differences were found between the two groups in terms of general characteristics and surgical and survival outcomes. In particular, there were no differences in terms of early and late complication frequency, 30 and 90-day mortality, R-status, recurrence, OS (54.26±33.72vs56.42±32.85 months,p=0.444) and DFS (46.05±36.14vs47.20±35.78 months,p=0.710). Mean tumor size was larger in the ESL group (4.72±2.30vs3.81±1.78 cm,p<0.001). Stage IIIA was the most prevalent stage in ESL group (34.8%), while stage IIB was the most prevalent in SSL group (34.3%)(p<0.001). In the multivariate analyses, nodal status was found to be the only independent predictive factor for overall survival. ESL gives comparable short- and long term outcomes to SSL. Appropriate preoperative staging and exclusion of metastases to mediastinal lymph nodes, as well as complete (R0) resection are essential for good long-term outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Sleeve resection is currently the gold standard procedure for centrally located non-small cell lung cancer (NSCLC). Extended sleeve lobectomies(ESL) consist in an atypical bronchoplasty with resection of more than one lobe, and carry several technical difficulties compared to simple sleeve lobectomy(SSL). Our study aimed to compare the outcomes of ESL and SSL for NSCLC.
METHODS
METHODS
This multicenter, retrospective, cohort study included 1314 patients who underwent ESL (155 patients) or SSL (1159 patients) between 2000 and 2018. The primary endpoints were: 30-day and 90-day mortality; overall survival(OS); Disease recurrence(DFS); complications.
RESULTS
RESULTS
No differences were found between the two groups in terms of general characteristics and surgical and survival outcomes. In particular, there were no differences in terms of early and late complication frequency, 30 and 90-day mortality, R-status, recurrence, OS (54.26±33.72vs56.42±32.85 months,p=0.444) and DFS (46.05±36.14vs47.20±35.78 months,p=0.710). Mean tumor size was larger in the ESL group (4.72±2.30vs3.81±1.78 cm,p<0.001). Stage IIIA was the most prevalent stage in ESL group (34.8%), while stage IIB was the most prevalent in SSL group (34.3%)(p<0.001). In the multivariate analyses, nodal status was found to be the only independent predictive factor for overall survival.
CONCLUSIONS
CONCLUSIONS
ESL gives comparable short- and long term outcomes to SSL. Appropriate preoperative staging and exclusion of metastases to mediastinal lymph nodes, as well as complete (R0) resection are essential for good long-term outcomes.
Identifiants
pubmed: 38246326
pii: S0003-4975(24)00012-2
doi: 10.1016/j.athoracsur.2024.01.003
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.