Lobectomy Versus Segmentectomy in Radiologically Pure Solid Small-Sized Non-Small Cell Lung Cancer
| Autor: | Terumoto Koike, Akihiko Kitahara, Teruaki Koike, Tadashi Aoki, Katsuo Yoshiya, Takehisa Hashimoto, Masanori Tsuchida, Seijiro Sato, Shin-ichi Toyabe |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms 030204 cardiovascular system & hematology Disease-Free Survival Pulmonary function testing 03 medical and health sciences 0302 clinical medicine McNemar's test Carcinoma Non-Small-Cell Lung medicine Carcinoma Humans Pneumonectomy Propensity Score Lung cancer Survival rate Aged Retrospective Studies Aged 80 and over business.industry Hazard ratio Middle Aged medicine.disease Surgery Radiography Survival Rate Log-rank test Treatment Outcome 030220 oncology & carcinogenesis Propensity score matching Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 101:1354-1360 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2015.10.048 |
| Popis: | Background The indication for limited resection of radiologically pure solid non-small cell lung cancer (NSCLC) is controversial owing to its invasive pathologic characteristics. This study was performed to compare the outcomes after lobectomy and segmentectomy in these NSCLC patients. Methods We retrospectively reviewed 251 patients with radiologically pure solid cT1a N0 M0 NSCLC who underwent lobectomy or segmentectomy, and the preoperative characteristics of the patients treated with the two operative techniques were matched using propensity score methods. Overall survival (OS) and disease-free survival (DFS) curves were compared using the log rank test, and differences in survival were also evaluated by the McNemar test. The preoperative factors and surgical procedure were analyzed with the multivariate Cox proportional hazards regression model to identify independent predictors of poor OS and DFS. Results In the propensity score matched lobectomy and segmentectomy groups (87 patients per group), the 5-year and 10-year OS rates were 85% versus 84% and 66% versus 63%, respectively; and the 5-year and 10-year DFS rates were 80% versus 77% and 64% versus 58%, respectively. There were no significant differences between the two groups in OS or DFS by the log rank test, and also no significant differences in 3-year, 5-year, or 7-year OS or DFS by the McNemar test. Although age, smoking status, pulmonary function, and carcinoembryonic antigen were identified as significant predictors of both OS and DFS, the surgical procedure was not identified. Conclusions Similar oncologic outcomes after lobectomy and segmentectomy were indicated among patients with radiologically pure solid small-sized NSCLC. |
| Databáze: | OpenAIRE |
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