Surgical treatment of lung cancer with adjacent lobe invasion in relation to fissure integrity

Autor: Giulio Maurizi, Andreina Pagini, Claudio Andreetti, Erino A. Rendina, Federico Venuta, Alfonso Fiorelli, Mohsen Ibrahim, Matteo Tiracorrendo, Antonio D'Andrilli, Marco Anile, Giovanni Natale, Valentina Peritore, Camilla Poggi, Mario Santini
Přispěvatelé: Andreetti, C., Poggi, C., Ibrahim, M., D'Andrilli, A., Maurizi, G., Tiracorrendo, M., Peritore, V., Rendina, E. A., Venuta, F., Anile, M., Pagini, A., Natale, G., Santini, M., Fiorelli, A.
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Lung Neoplasms
fissure integrity
pleural invasion
animal diseases
Adjacent lobe
lcsh:RC254-282
surgery
03 medical and health sciences
0302 clinical medicine
Carcinoma
Non-Small-Cell Lung
medicine
Humans
In patient
Neoplasm Invasiveness
Stage (cooking)
Surgical treatment
Lung cancer
Pneumonectomy
Lymph node
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Incidence (epidemiology)
adjacent lobe
lung cancer
General Medicine
Original Articles
respiratory system
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Lobe
respiratory tract diseases
Survival Rate
030104 developmental biology
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Population study
Original Article
Female
Radiology
Neoplasm Recurrence
Local
business
Follow-Up Studies
Zdroj: Thoracic Cancer
Thoracic Cancer, Vol 11, Iss 2, Pp 232-242 (2020)
ISSN: 1759-7714
1759-7706
Popis: Background Tumor with adjacent lobe invasion (T‐ALI) is an uncommon condition. Controversy still exists regarding the optimal resection of adjacent lobe invasion, and the prognostic value in relation to fissure integrity at the tumor invasion point. The aims of this paper were to evaluate the prognosis of T‐ALI with regard to fissure integrity, and type of resection. Methods This was a retrospective multicenter study which included all consecutive patients with T‐ALI undergoing surgical treatment. Based on radiological, intraoperative and histological findings, T‐ALI patients were differentiated into two groups based on whether the fissure was complete (T‐ALI‐A group) or incomplete (T‐ALI‐D Group) at the level of tumor invasion point. Clinico‐pathological features and survival of two study groups were analyzed and compared. Results Study population included 135 patients, of these 98 (72%) were included into T‐ALI‐A group, and 37 (38%) into T‐ALI‐D Group. T‐ALI‐D patients had better overall survival than T‐ALI‐A patients (63.9 ± 7.0 vs. 48.9 ± 3.9; respectively, P = 0.01) who presented with a higher incidence of lymph node involvement (35% vs. 4%; P = 0.004), and recurrence rate (43% vs. 16%; P = 0.01). At multivariable analysis, T‐ALI‐D (P = 0.01), pN0 stage (P = 0.0002), and pT≤5 cm (P = 0.0001) were favorable survival prognostic factors. Conclusions T‐ALI‐D presented a better prognosis than T‐ALI‐A while extent of resection had no effect on survival. Thus, in patients with small T‐ALI‐D and without lymph node involvement, sublobar resection of adjacent lobe rather than lobectomy could be indicated. Key points The extent of resection of adjacent lobe had no effect on survival while T‐ALI‐D, pN0 stage, and pT≤5 cm were significant prognostic factors. In patients with small T‐ALI‐D and without lymph node involvement, sublobar resection of adjacent lobe could be indicated as an alternative to lobectomy.
Databáze: OpenAIRE
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