Cargando…
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
BACKGROUND: 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. METHODS: Patients...
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947415/ https://www.ncbi.nlm.nih.gov/pubmed/33718031 http://dx.doi.org/10.21037/tlcr-20-1217 |
_version_ | 1783663221834514432 |
---|---|
author | Yu, Xiangyang Zhang, Rusi Zhang, Mengqi Lin, Yongbin Zhang, Xuewen Wen, Yingsheng Yang, Longjun Huang, Zirui Wang, Gongming Zhao, Dechang Gonzalez, Michel Baste, Jean-Marc Petersen, Rene Horsleben Ng, Calvin S. H. Brunelli, Alessandro Zheng, Lie Zhang, Lanjun |
author_facet | Yu, Xiangyang Zhang, Rusi Zhang, Mengqi Lin, Yongbin Zhang, Xuewen Wen, Yingsheng Yang, Longjun Huang, Zirui Wang, Gongming Zhao, Dechang Gonzalez, Michel Baste, Jean-Marc Petersen, Rene Horsleben Ng, Calvin S. H. Brunelli, Alessandro Zheng, Lie Zhang, Lanjun |
author_sort | Yu, Xiangyang |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. |
format | Online Article Text |
id | pubmed-7947415 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-79474152021-03-12 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 Yu, Xiangyang Zhang, Rusi Zhang, Mengqi Lin, Yongbin Zhang, Xuewen Wen, Yingsheng Yang, Longjun Huang, Zirui Wang, Gongming Zhao, Dechang Gonzalez, Michel Baste, Jean-Marc Petersen, Rene Horsleben Ng, Calvin S. H. Brunelli, Alessandro Zheng, Lie Zhang, Lanjun Transl Lung Cancer Res Original Article BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. AME Publishing Company 2021-02 /pmc/articles/PMC7947415/ /pubmed/33718031 http://dx.doi.org/10.21037/tlcr-20-1217 Text en 2021 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Yu, Xiangyang Zhang, Rusi Zhang, Mengqi Lin, Yongbin Zhang, Xuewen Wen, Yingsheng Yang, Longjun Huang, Zirui Wang, Gongming Zhao, Dechang Gonzalez, Michel Baste, Jean-Marc Petersen, Rene Horsleben Ng, Calvin S. H. Brunelli, Alessandro Zheng, Lie Zhang, Lanjun 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 |
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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947415/ https://www.ncbi.nlm.nih.gov/pubmed/33718031 http://dx.doi.org/10.21037/tlcr-20-1217 |
work_keys_str_mv | AT yuxiangyang segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT zhangrusi segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT zhangmengqi segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT linyongbin segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT zhangxuewen segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT wenyingsheng segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT yanglongjun segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT huangzirui segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT wanggongming segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT zhaodechang segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT gonzalezmichel segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT bastejeanmarc segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT petersenrenehorsleben segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT ngcalvinsh segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT brunellialessandro segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT zhenglie segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT zhanglanjun segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm AT segmentalresectionisassociatedwithdecreasedsurvivalinpatientswithstageianonsmallcelllungcancerwithatumorsizeof2130mm |