A Multicenter Retrospective Case-Control Study on Simple vs Extended Sleeve Lobectomies.

Autor:	Campisi A; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China; Department of Thoracic Surgery, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy. Electronic address: campisi.alessi088@gmail.com., Dell'Amore A; Department of Cardiothoracic Surgery and Vascular Sciences, Padua University Hospital, University of Padua, Padua, Italy., Faccioli E; Department of Cardiothoracic Surgery and Vascular Sciences, Padua University Hospital, University of Padua, Padua, Italy., Fang W; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China., Chen T; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China., Ji C; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China., Gabryel P; Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland., Sielewicz M; Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland., Piwkowski C; Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland., Park S; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea., Kim YT; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea., Bongiolatti S; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy., Mugnaini G; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy., Voltolini L; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy., Catelli C; Department of Cardiothoracic Surgery and Vascular Sciences, Padua University Hospital, University of Padua, Padua, Italy., Giovannetti R; Department of Thoracic Surgery, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy., Infante M; Department of Thoracic Surgery, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy., Bertolaccini L; Department of Thoracic Surgery, Istituto Europeo di Oncologia (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy., Spaggiari L; Department of Thoracic Surgery, Istituto Europeo di Oncologia (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy., Ehrsam J; Center for Surgery Zurich, Thoracic Surgery, Hirslanden Clinic, Zurich, Switzerland., Schöb O; Center for Surgery Zurich, Thoracic Surgery, Hirslanden Clinic, Zurich, Switzerland., Inci I; Center for Surgery Zurich, Thoracic Surgery, Hirslanden Clinic, Zurich, Switzerland., Rea F; Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2024 Aug; Vol. 118 (2), pp. 375-383. Date of Electronic Publication: 2024 Jan 20.
DOI:	10.1016/j.athoracsur.2024.01.003
Abstrakt:	Background: Sleeve resection is currently the gold standard procedure for centrally located non-small cell lung cancer (NSCLC). Extended sleeve lobectomy (ESL) consists of an atypical bronchoplasty with resection of >1 lobe and carries several technical difficulties compared with simple sleeve lobectomy (SSL). Our study compared the outcomes of ESL and SSL for NSCLC. Methods: This multicenter, retrospective, cohort study included 1314 patients who underwent ESL (155 patients) or SSL (1159 patients) between 2000 and 2018. The primary end points were 30-day and 90-day mortality, overall survival (OS), disease-free survival (DFS), and complications. Results: No differences were found between the 2 groups in general characteristics and surgical and survival outcomes. In particular, there were no differences in early and late complication frequency, 30- and 90-day mortality, R status, recurrence, OS (54.26 ± 33.72 months vs 56.42 ± 32.85 months, P = .444), and DFS (46.05 ± 36.14 months vs 47.20 ± 35.78 months, P = .710). Mean tumor size was larger in the ESL group (4.72 ± 2.30 cm vs 3.81 ± 1.78 cm, P < .001). Stage IIIA was the most prevalent stage in ESL group (34.8%), whereas stage IIB was the most prevalent in SSL group (34.3%; P < .001). The multivariate analyses found nodal status was the only independent predictive factor for OS. 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. (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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