Segmental resection is associated with decreased survival in patients with stage IA non-small cell lung cancer with a tumor size of 21-30 mm.

Details

Serval ID
serval:BIB_3DC14D1CA4BA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Segmental resection is associated with decreased survival in patients with stage IA non-small cell lung cancer with a tumor size of 21-30 mm.
Journal
Translational lung cancer research
Author(s)
Yu X., Zhang R., Zhang M., Lin Y., Zhang X., Wen Y., Yang L., Huang Z., Wang G., Zhao D., Gonzalez M., Baste J.M., Petersen R.H., Ng CSH, Brunelli A., Zheng L., Zhang L.
Working group(s)
written on behalf of the AME Thoracic Surgery Collaborative Group
ISSN
2218-6751 (Print)
ISSN-L
2218-6751
Publication state
Published
Issued date
02/2021
Peer-reviewed
Oui
Volume
10
Number
2
Pages
900-913
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The feasibility of segmental resection for early-stage non-small cell lung cancer (NSCLC) is still controversial. This study aimed to compare survival outcomes following lobectomy and segmental resection in patients with pathological T1cN0M0 (tumor size 21-30 mm) NSCLC.
Patients diagnosed between 1998 and 2016 with pathological stage IA NSCLC and with tumors measuring 21-30 mm were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The observational outcomes were cancer-specific survival (CSS) and overall survival (OS) at 5 years. Univariate survival analysis was carried out to identify potential prognostic factors of prolonged survival. Cox proportional hazards model was used to adjust for confounding factors. Additionally, pairwise comparisons were conducted between lobectomy and segmental resection for CSS and OS, and forest plots were drawn.
Of the 9,580 patients analyzed, 400 patients (4.2%) underwent segmental resections. Patients with older age (P<0.001), smaller tumors (P<0.001), and left-sided tumors (P=0.002) were more likely to receive segmental resection. No difference was found in the operative mortality rates between the segmental resection group and the lobectomy group (1.0% vs. 1.2%, P=0.707). The CSS (HR, 1.429; 95% CI, 1.166-1.752; P=0.001) and OS (HR, 1.348; 95% CI, 1.176-1.544; P<0.001) in the segmental resection group were significantly worse than those in the lobectomy group. Subgroup analyses by age, year of diagnosis, sex, tumor size, histology, grade, and the number of dissected lymph nodes also confirmed that lobectomy was associated with improved CSS and OS.
Lobectomy and thorough removal of lymph nodes should continue to be the recommended standard of care for patients with surgically resectable stage IA NSCLC with tumor size of 21-30 mm.
Keywords
Early-stage, Surveillance, Epidemiology, and End Results (SEER), lobectomy, segmental resection
Pubmed
Web of science
Open Access
Yes
Create date
27/03/2021 16:55
Last modification date
08/05/2021 6:32
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