Patients with Pulmonary Artery Reconstruction or Double Sleeve Resection Show Inferior Survival than Patients with Bronchial Sleeve Resection for Non-small Cell Lung Cancer.

Autor:	Herrmann D; Klinik für Thoraxchirurgie, Thoraxzentrum Ruhrgebiet, Herne, Germany., Gencheva-Bozhkova P; Klinik für Thoraxchirurgie, Thoraxzentrum Ruhrgebiet, Herne, Germany., Starova U; Klinik für Thoraxchirurgie, Thoraxzentrum Ruhrgebiet, Herne, Germany., Luta LA; Klinik für Thoraxchirurgie, Thoraxzentrum Ruhrgebiet, Herne, Germany., Hamouri S; Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan., Ewig S; Klinik für Pneumologie, Infektiologie und Beatmungsmedizin, Thoraxzentrum Ruhrgebiet, Herne, Germany., Oggiano M; Klinik für Thoraxchirurgie, Thoraxzentrum Ruhrgebiet, Herne, Germany., Hecker E; Klinik für Thoraxchirurgie, Thoraxzentrum Ruhrgebiet, Herne, Germany., Scheubel R; Klinik für Thoraxchirurgie, Fachkliniken Wangen, Wangen, Germany.
Jazyk:	angličtina
Zdroj:	Zentralblatt fur Chirurgie [Zentralbl Chir] 2024 Sep 03. Date of Electronic Publication: 2024 Sep 03.
DOI:	10.1055/a-2348-0694
Abstrakt:	Sleeve lobectomy or resection with pulmonary artery reconstruction is a technique that allows for resection of locally advanced central lung carcinoma, preserving lung function, and is associated with lower morbidity and mortality than pneumonectomy. This survey aimed to assess the long-term survival comparing different types of sleeve lobectomy and identify risk factors affecting survival.All consecutive patients who underwent anatomical resection for primary non-small cell lung cancer with bronchial sleeve or pulmonary artery reconstruction in our department between September 2003 and September 2021 were included in this study. Cases with carinal sleeve pneumonectomy were excluded. Data were evaluated retrospectively.Bronchial sleeve resection was performed in 227 patients, double sleeve resection in 67 patients, and 45 cases underwent isolated lobectomy with pulmonary artery reconstruction. The mean follow-up was 33.5 months. The 5-year survival was 58.5% for patients after bronchial sleeve, 43.2% after double sleeve, and 36.8% after resection with vascular reconstruction. The difference in overall survival of these three groups was statistically significant (p = 0.012). However, the UICC stage was higher in cases with double sleeve resection or resection with vascular reconstruction (p = 0.016). Patients with lymph node metastases showed shorter overall survival (p = 0.033). The 5-year survival rate was 60.1% for patients with N0 and 47% for patients with N1 and N2 status. Induction therapy, vascular sleeve resection, and double sleeve resection were independent adverse predictors for overall survival in multivariate analysis.Sleeve lobectomy and resection with vascular reconstruction are safe procedures with good long-term survival. However, double sleeve resection and vascular sleeve resection were adverse predictors of survival, possibly due to a higher UICC stage in these patients. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu