Oncologic outcomes of segmentectomy for stage IA radiological solid-predominant lung cancer >2 cm in maximum tumour size.

IF 1.6 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Interactive cardiovascular and thoracic surgery Pub Date : 2022-11-08 DOI:10.1093/icvts/ivac246
Aritoshi Hattori, Takeshi Matsunaga, Mariko Fukui, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
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引用次数: 3

Abstract

Objectives: We aimed to compare the outcomes of segmentectomy with those of lobectomy in clinical-stage IA radiological solid-predominant non-small-cell lung cancer (NSCLC) >2 cm in maximum tumour size.

Methods: A retrospective review was performed for radiological solid-predominant NSCLC >2-3 cm in maximum tumour size with a ground-glass opacity component on thin-section computed tomography. Multivariable or propensity score-matched analyses were performed to control for confounders for survival. Overall survival (OS) was analysed using a Kaplan-Meier estimation.

Results: Of the 215 eligible cases, segmentectomy and lobectomy were performed in 46 and 169 patients. Multivariable analysis revealed that standardized uptake value (hazard ratio: 1.148, 95% confidence interval: 1.032-1.276, P = 0.011) was an independently significant prognosticators of OS, while the operative mode was not associated (hazard ratio: 0.635, 95% confidence interval: 0.132-3.049, P = 0.570). The 5 y-OS was excellent and did not differ significantly between segmentectomy and lobectomy (95.5% vs 90.2%; P = 0.697), which was also shown in the propensity score analysis (96.8% vs 94.0%; P = 0.406), with a median follow-up time of 5.2 years. Locoregional recurrence was found in 2 (4.3%) segmentectomy and 13 (7.7%) lobectomy (P = 0.443). In the subgroup analysis stratified by solid component size, the 5 y-OS was similar between segmentectomy and lobectomy in the c-T1b and c-T1c groups, respectively [c-T1b (n = 163): 94.1% vs 91.8%; P = 0.887 and c-T1c (n = 52): 100% vs 84.9%; P = 0.197].

Conclusions: Segmentectomy showed similar oncological results compared to lobectomy in solid-predominant NSCLC with a ground-glass opacity component >2-3 cm in maximum tumour size. More prospective randomized trials are needed to adequately expand the indication of anatomic segmentectomy for early-stage NSCLC.

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对最大肿瘤大小> 2cm的IA期放射学实性肺癌进行节段切除术的肿瘤学结果。
目的:我们旨在比较最大肿瘤大小> 2cm的IA期放射学实性非小细胞肺癌(NSCLC)的节段切除术和肺叶切除术的结果。方法:回顾性回顾了在薄层计算机断层扫描上有磨玻璃不透明成分的最大肿瘤大小>2-3 cm的放射学实性非小细胞肺癌。采用多变量或倾向评分匹配分析来控制混杂因素对生存的影响。采用Kaplan-Meier估计分析总生存期(OS)。结果:215例患者中,46例行节段切除术,169例行肺叶切除术。多变量分析显示,标准化摄取值(风险比:1.148,95%可信区间:1.032 ~ 1.276,P = 0.011)是OS的独立显著预测指标,而手术方式无相关性(风险比:0.635,95%可信区间:0.132 ~ 3.049,P = 0.570)。5 y-OS非常好,节段切除术和肺叶切除术之间无显著差异(95.5% vs 90.2%;P = 0.697),倾向评分分析也显示了这一点(96.8% vs 94.0%;P = 0.406),中位随访时间5.2年。节段切除术2例(4.3%)和肺叶切除术13例(7.7%)出现局部复发(P = 0.443)。在按实体成分大小分层的亚组分析中,c-T1b组和c-T1c组的节段切除术和肺叶切除术的5 y-OS相似,分别为[c-T1b (n = 163): 94.1% vs 91.8%;P = 0.887, c-T1c (n = 52): 100% vs 84.9%;p = 0.197]。结论:对于最大肿瘤大小>2-3 cm的磨玻璃混浊成分,以实体为主的非小细胞肺癌,与肺叶切除术相比,节段切除术的肿瘤学结果相似。需要更多的前瞻性随机试验来充分扩大解剖节段切除术治疗早期非小细胞肺癌的适应症。
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来源期刊
Interactive cardiovascular and thoracic surgery
Interactive cardiovascular and thoracic surgery CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
0.00%
发文量
292
审稿时长
2-4 weeks
期刊介绍: Interactive CardioVascular and Thoracic Surgery (ICVTS) publishes scientific contributions in the field of cardiovascular and thoracic surgery, covering all aspects of surgery of the heart, vessels and the chest. The journal publishes a range of article types including: Best Evidence Topics; Brief Communications; Case Reports; Original Articles; State-of-the-Art; Work in Progress Report.
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