Survival after thermal ablation versus wedge resection for stage I non-small cell lung cancer < 1 cm and 1 to 2 cm: evidence from the US SEER database

IF 3.5 2区 医学 Q2 ONCOLOGY Cancer Imaging Pub Date : 2024-07-11 DOI:10.1186/s40644-024-00733-4
Shelly Yim, Wei Chan Lin, Jung Sen Liu, Ming Hong Yen
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Abstract

This study compared the survival outcomes after thermal ablation versus wedge resection in patients with stage I non-small cell lung cancer (NSCLC) ≤ 2 cm. Data from the United States (US) National Cancer Institute Surveillance Epidemiology and End Results (SEER) database from 2004 to 2019 were retrospectively analyzed. Patients with stage I NSCLC and lesions ≤ 2 cm who received thermal ablation or wedge resection were included. Patients who received chemotherapy or radiotherapy were excluded. Propensity-score matching (PSM) was applied to balance the baseline characteristics between patients who underwent the two procedures. Univariate and Cox regression analyses were performed to determine the associations between study variables, overall survival (OS), and cancer-specific survival (CSS). After PSM, 328 patients remained for analysis. Multivariable Cox regression analysis revealed, compared to wedge resection, thermal ablation was significantly associated with a greater risk of poor OS (adjusted HR [aHR]: 1.34, 95% CI: 1.09–1.63, p = 0.004) but not CSS (aHR: 1.28, 95% CI: 0.96–1.71, p = 0.094). In stratified analyses, no significant differences were observed with respect to OS and CSS between the two procedures regardless of histology and grade. In patients with tumor size 1 to 2 cm, compared to wedge resection, thermal ablation was significantly associated with a higher risk of poor OS (aHR: 1.35, 95% CI: 1.10–1.66, p = 0.004). In contrast, no significant difference was found on OS and CSS between thermal ablation and wedge resection among those with tumor size < 1 cm. In patients with stage I NSCLC and tumor size < 1 cm, thermal ablation has similar OS and CSS with wedge resection.
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小于 1 厘米和 1 至 2 厘米的 I 期非小细胞肺癌热消融与楔形切除术后的存活率:来自美国 SEER 数据库的证据
这项研究比较了≤2厘米的I期非小细胞肺癌(NSCLC)患者热消融与楔形切除术后的生存结果。研究人员对美国国家癌症研究所监测流行病学和最终结果(SEER)数据库2004年至2019年的数据进行了回顾性分析。纳入了接受热消融或楔形切除术的病灶≤2厘米的I期NSCLC患者。不包括接受化疗或放疗的患者。采用倾向分数匹配法(PSM)来平衡接受两种手术的患者的基线特征。为了确定研究变量、总生存率(OS)和癌症特异性生存率(CSS)之间的关系,进行了单变量和 Cox 回归分析。在 PSM 之后,仍有 328 名患者可供分析。多变量 Cox 回归分析显示,与楔形切除术相比,热消融与较差的 OS 风险显著相关(调整 HR [aHR]:1.34,95% CI:1.09-1.63,p = 0.004),但与 CSS 无关(aHR:1.28,95% CI:0.96-1.71,p = 0.094)。在分层分析中,无论组织学和分级如何,两种手术的OS和CSS均无明显差异。在肿瘤大小为1至2厘米的患者中,与楔形切除术相比,热消融术与较高的不良OS风险显著相关(aHR:1.35,95% CI:1.10-1.66,p = 0.004)。相比之下,在肿瘤大小小于1厘米的患者中,热消融与楔形切除术在OS和CSS方面无明显差异。对于肿瘤大小小于1厘米的I期NSCLC患者,热消融与楔形切除术的OS和CSS相似。
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来源期刊
Cancer Imaging
Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
7.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.
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