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Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Background. Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of th...

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Autores principales: Piloni, Davide, Bertuccio, Francesco R., Primiceri, Cristiano, Rinaldi, Pietro, Chino, Vittorio, Abbott, David Michael, Sottotetti, Federico, Bortolotto, Chandra, Agustoni, Francesco, Saddi, Jessica, Stella, Giulia M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967492/
https://www.ncbi.nlm.nih.gov/pubmed/36836096
http://dx.doi.org/10.3390/jcm12041561
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author Piloni, Davide
Bertuccio, Francesco R.
Primiceri, Cristiano
Rinaldi, Pietro
Chino, Vittorio
Abbott, David Michael
Sottotetti, Federico
Bortolotto, Chandra
Agustoni, Francesco
Saddi, Jessica
Stella, Giulia M.
author_facet Piloni, Davide
Bertuccio, Francesco R.
Primiceri, Cristiano
Rinaldi, Pietro
Chino, Vittorio
Abbott, David Michael
Sottotetti, Federico
Bortolotto, Chandra
Agustoni, Francesco
Saddi, Jessica
Stella, Giulia M.
author_sort Piloni, Davide
collection PubMed
description Background. Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. Patients and Methods. Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. Results. The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient’s gender. Conclusions. Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer.
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spelling pubmed-99674922023-02-27 Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage Piloni, Davide Bertuccio, Francesco R. Primiceri, Cristiano Rinaldi, Pietro Chino, Vittorio Abbott, David Michael Sottotetti, Federico Bortolotto, Chandra Agustoni, Francesco Saddi, Jessica Stella, Giulia M. J Clin Med Article Background. Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. Patients and Methods. Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. Results. The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient’s gender. Conclusions. Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer. MDPI 2023-02-16 /pmc/articles/PMC9967492/ /pubmed/36836096 http://dx.doi.org/10.3390/jcm12041561 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Piloni, Davide
Bertuccio, Francesco R.
Primiceri, Cristiano
Rinaldi, Pietro
Chino, Vittorio
Abbott, David Michael
Sottotetti, Federico
Bortolotto, Chandra
Agustoni, Francesco
Saddi, Jessica
Stella, Giulia M.
Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage
title Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage
title_full Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage
title_fullStr Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage
title_full_unstemmed Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage
title_short Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage
title_sort smoking habit and respiratory function predict patients’ outcome after surgery for lung cancer, irrespective of histotype and disease stage
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967492/
https://www.ncbi.nlm.nih.gov/pubmed/36836096
http://dx.doi.org/10.3390/jcm12041561
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