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Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy
OBJECTIVES: Sublobar resection, including wedge resection and segmentectomy, is non-inferior to lobectomy in early-stage non-small cell lung cancer treatment. We aimed to compare the risk of postoperative cognitive dysfunction (POCD) between sublobar resection and lobectomy. METHODS: We conducted a...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628534/ https://www.ncbi.nlm.nih.gov/pubmed/37713465 http://dx.doi.org/10.1093/ejcts/ezad319 |
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author | Zang, Nailiang Shen, Wei Li, Shiyin Chen, Liqi Ai, Qing Huang, Weimeng Lan, Lan Liu, Jun Wang, Wei Cui, Fei Huang, Jun Shao, Wenlong Huang, Xiaoyun Xu, Pingyi He, Jianxing |
author_facet | Zang, Nailiang Shen, Wei Li, Shiyin Chen, Liqi Ai, Qing Huang, Weimeng Lan, Lan Liu, Jun Wang, Wei Cui, Fei Huang, Jun Shao, Wenlong Huang, Xiaoyun Xu, Pingyi He, Jianxing |
author_sort | Zang, Nailiang |
collection | PubMed |
description | OBJECTIVES: Sublobar resection, including wedge resection and segmentectomy, is non-inferior to lobectomy in early-stage non-small cell lung cancer treatment. We aimed to compare the risk of postoperative cognitive dysfunction (POCD) between sublobar resection and lobectomy. METHODS: We conducted a prospective cohort study. Patients with sublobar resection or lobectomy were divided into the sublobar group or the lobar group, respectively. Cognition was assessed before and after surgery with Montreal Cognitive Assessment and Minimum Mental State Examination tests. POCD is defined as Z score of Montreal Cognitive Assessment change ≤–1.96. Propensity score matching (PSM) was performed to make demographics well-balanced between the 2 groups. RESULTS: A total of 335 patients were enrolled. Both the postoperative 1-day POCD rate (sublobar 5.5% vs lobar 18.2%, P < 0.001) and the postoperative 1-month POCD rate (sublobar 7.9% vs lobar 21.8%, P < 0.001) were significantly lower in the sublobar group compared with lobar group, with demographics unbalanced between the 2 groups. In the 133 demographics-matched pairs obtained by PSM, both the postoperative 1-day POCD rate (sublobar 5.3% vs lobar 17.3%, P = 0.005) and the postoperative 1-month POCD rate (sublobar 8.3% vs lobar 18.8%, P = 0.018) remained significantly lower in the sublobar group than in the lobar group. The incidences of postoperative 1-day (P = 0.109) and postoperative 1-month (P = 0.026) Minimum Mental State Examination abnormity were also lower in the sublobar group than in the lobar group but only the latter was with statistical significance after PSM. CONCLUSIONS: Sublobar resection has an advantage over lobectomy in preventing POCD. Our findings might be a reference for selecting the most suitable type of resection for non-small-cell lung cancer patients. |
format | Online Article Text |
id | pubmed-10628534 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106285342023-11-08 Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy Zang, Nailiang Shen, Wei Li, Shiyin Chen, Liqi Ai, Qing Huang, Weimeng Lan, Lan Liu, Jun Wang, Wei Cui, Fei Huang, Jun Shao, Wenlong Huang, Xiaoyun Xu, Pingyi He, Jianxing Eur J Cardiothorac Surg Thoracic OBJECTIVES: Sublobar resection, including wedge resection and segmentectomy, is non-inferior to lobectomy in early-stage non-small cell lung cancer treatment. We aimed to compare the risk of postoperative cognitive dysfunction (POCD) between sublobar resection and lobectomy. METHODS: We conducted a prospective cohort study. Patients with sublobar resection or lobectomy were divided into the sublobar group or the lobar group, respectively. Cognition was assessed before and after surgery with Montreal Cognitive Assessment and Minimum Mental State Examination tests. POCD is defined as Z score of Montreal Cognitive Assessment change ≤–1.96. Propensity score matching (PSM) was performed to make demographics well-balanced between the 2 groups. RESULTS: A total of 335 patients were enrolled. Both the postoperative 1-day POCD rate (sublobar 5.5% vs lobar 18.2%, P < 0.001) and the postoperative 1-month POCD rate (sublobar 7.9% vs lobar 21.8%, P < 0.001) were significantly lower in the sublobar group compared with lobar group, with demographics unbalanced between the 2 groups. In the 133 demographics-matched pairs obtained by PSM, both the postoperative 1-day POCD rate (sublobar 5.3% vs lobar 17.3%, P = 0.005) and the postoperative 1-month POCD rate (sublobar 8.3% vs lobar 18.8%, P = 0.018) remained significantly lower in the sublobar group than in the lobar group. The incidences of postoperative 1-day (P = 0.109) and postoperative 1-month (P = 0.026) Minimum Mental State Examination abnormity were also lower in the sublobar group than in the lobar group but only the latter was with statistical significance after PSM. CONCLUSIONS: Sublobar resection has an advantage over lobectomy in preventing POCD. Our findings might be a reference for selecting the most suitable type of resection for non-small-cell lung cancer patients. Oxford University Press 2023-09-15 /pmc/articles/PMC10628534/ /pubmed/37713465 http://dx.doi.org/10.1093/ejcts/ezad319 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Thoracic Zang, Nailiang Shen, Wei Li, Shiyin Chen, Liqi Ai, Qing Huang, Weimeng Lan, Lan Liu, Jun Wang, Wei Cui, Fei Huang, Jun Shao, Wenlong Huang, Xiaoyun Xu, Pingyi He, Jianxing Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
title | Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
title_full | Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
title_fullStr | Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
title_full_unstemmed | Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
title_short | Sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
title_sort | sublobar resection reduces the risk of postoperative cognitive dysfunction compared with lobectomy |
topic | Thoracic |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628534/ https://www.ncbi.nlm.nih.gov/pubmed/37713465 http://dx.doi.org/10.1093/ejcts/ezad319 |
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