Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung
| Autor: | Alexander S. Farivar, Eric Vallières, Farhood Farjah, Francesco Guerrera, Kimberly E Costas, Stefano Margaritora, Stephen J. Kaplan, Ralph W. Aye, Pier Luigi Filosso, Alessandra Siciliani, Amir A Sarkeshik, Michal Hubka, Andrea Imperatori, Brian E. Louie, Maria Cattoni, Grace Wandell, Catherine Mann, Nicola Rotolo, Lisa M. Brown |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Internationality Lung Neoplasms Carcinoid Tumor Kaplan-Meier Estimate 030204 cardiovascular system & hematology Risk Assessment Disease-Free Survival Cohort Studies 03 medical and health sciences 0302 clinical medicine Cause of Death Settore MED/21 - CHIRURGIA TORACICA medicine Humans Neoplasm Invasiveness Pneumonectomy Propensity Score Survival analysis Cause of death Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Lung business.industry Proportional hazards model Female Middle Aged Neoplasm Recurrence Local Prognosis Survival Analysis Retrospective cohort study Confidence interval Surgery medicine.anatomical_structure Neoplasm Recurrence 030228 respiratory system Local Propensity score matching Cardiology and Cardiovascular Medicine business Cohort study |
| Popis: | Background The role of sublobar resection in the treatment of pulmonary typical carcinoids is controversial. This study aims to compare long-term outcomes between sublobar and lobar resections in patients with peripheral typical carcinoid. Methods We retrospectively compared consecutive patients who underwent curative sublobar resection with patients who underwent lobectomy for cT1-3 N0 M0 peripheral pulmonary typical carcinoid in eight centers between 2000 and 2015. Primary outcomes were rates and patterns of recurrence and overall survival. Cox regression modeling was performed to identify factors influencing overall survival and recurrence. Propensity score analysis was done, and overall survival was compared between the two groups. Results In all, 177 patients were analyzed, consisting of 74 sublobar resections and 103 lobectomies, with a total of 857 person-years of follow-up. The R1 resection rates were 7% and 1% after sublobar resection and lobectomy, respectively (P = .08). One of 5 patients with sublobar R1 resection had recurrence. Recurrence rate was 0.02 (95% confidence interval [CI]: 0.009 to 0.044) per person-year of follow-up after sublobar resection and 0.008 (95% CI: 0.003 to 0.02) after lobectomy (P = .15). Five-year survival rates were 91.7% (95% CI: 78.5% to 96.9%) and 97.4% (95% CI: 90.1% to 99.4%) after sublobar and lobar resection, respectively (P = .08). Extent of resection was not a predictor of recurrence or survival. Propensity score analysis confirmed a similar survival and freedom from recurrence between the two groups. Conclusions Sublobar resection of peripheral cT1-3 N0 M0 pulmonary typical carcinoid was not associated with worse short- or long-term outcomes compared with lobectomy. In select patients, sublobar resection may be considered for treatment of peripheral typical carcinoids if an R0 resection is obtained. |
| Databáze: | OpenAIRE |
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