扩展袖式肺叶切除术(ESL)与标准袖式肺叶切除术(SL)的单中心临床经验。

IF 4 2区 医学 Q2 ONCOLOGY Translational lung cancer research Pub Date : 2024-08-31 Epub Date: 2024-08-28 DOI:10.21037/tlcr-24-546
Haoyou Wang, Wei Wang, Peng Zu, Gregor J Kocher, Mara B Antonoff, Alberto Lopez-Pastorini, Chenlei Zhang, Wei Chen, Hongxu Liu
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引用次数: 0

摘要

背景:袖带肺叶切除术(SL)和扩大SL(ESL)旨在保留肺功能,提高患者的生活质量,同时确保肿瘤治疗效果,是治疗中央型非小细胞肺癌(NSCLC)的重要手术选择。本研究旨在比较 SL 和 ESL 在 NSCLC 患者中的围手术期不良事件和长期生存率,对手术结果、并发症和生存率进行全面回顾,以评估 SL 和 ESL 在胸部肿瘤学中的作用:这项单中心回顾性研究评估了 2014 年 6 月至 2022 年 1 月期间接受 SL 或 ESL 的 NSCLC 患者的疗效。根据特定的纳入标准选择患者,并对患者的术后疗效、总生存期(OS)和无病生存期(DFS)进行统计分析:共有 218 名患者符合纳入标准。结果:共有 218 名患者符合纳入标准,其中 33 人接受了 ESL,185 人接受了 SL。与 SL 相比,ESL 的手术时间更长,R0 切除率更高(93.9% 对 78.8%,P=0.047)。尽管 ESL 比 SL 更为复杂,但两组患者的围手术期并发症或死亡率并无明显差异。对倾向得分匹配(PSM)数据进行了生存分析,结果显示 ESL 组的 OS 和 DFS 优于 SL 组。高龄、晚期结节(N)状态和非R0切除是预后较差的重要预测因素:ESL是治疗中心位置NSCLC的一种可行且有效的替代方法,其R0切除率更高,生存率与SL相当,且不会增加III-IV级并发症的风险。为了验证这些研究结果并完善手术技术,还需要进行更大规模的研究。
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Single-center clinical experience of extended sleeve lobectomy (ESL) versus standard sleeve lobectomy (SL).

Background: Sleeve lobectomy (SL) and extended SL (ESL), which aim to preserve pulmonary function and enhance the quality of life of patients while ensuring oncological outcomes, are valuable surgical options for the treatment of centrally located non-small cell lung cancer (NSCLC). This study aimed to compare perioperative adverse events and long-term survival between SL and ESL in NSCLC patients, providing a comprehensive review of surgical outcomes, complications, and survival to assess the roles of SL and ESL in thoracic oncology.

Methods: This single-center retrospective study assessed the outcomes of NSCLC patients who underwent SL or ESL from June 2014 to January 2022. The patients were selected based on specific inclusion criteria, and statistical analyses were conducted to examine the postoperative outcomes, overall survival (OS), and disease-free survival (DFS) of the patients.

Results: A total of 218 patients met the inclusion criteria. Among 218 patients, 33 underwent ESL and 185 underwent SL. Compared to SL, ESL was associated with longer operative times and higher R0 resection rates (93.9% vs. 78.8%, P=0.047). Despite the higher complexity of ESL compared to SL, there were no significant differences in the perioperative complications or mortality rates between the groups. Survival analysis was conducted on the propensity score matching (PSM) data, the results demonstrated superior OS and DFS in the ESL group compared to the SL group. Advanced age, more advanced nodal (N) status, and non-R0 resection were significant predictors of poorer prognosis.

Conclusions: ESL is a feasible and effective alternative for treating centrally located NSCLC, with better R0 resection rates and comparable survival outcomes to SL, without increasing the risk of grade III-IV complications. Further studies with larger cohorts need to be conducted to validate these findings and refine the surgical techniques.

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来源期刊
CiteScore
7.20
自引率
2.50%
发文量
137
期刊介绍: Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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