Survival Rates After Lobectomy, Segmentectomy, and Wedge Resection for Non-Small Cell Lung Cancer
Survival Rates After Lobectomy, Segmentectomy, and Wedge Resection for Non-Small Cell Lung Cancer
复制标题
DOI：
10.1016/j.athoracsur.2018.01.032
复制
发表时间：
2018-05-01
影响因子：
4.6
通讯作者：
Hu, Jian
中科院分区：
文献类型：
--
作者：
Cao, Jinlin;Yuan, Ping;Hu, Jian
背景本研究旨在比较IA期非小细胞肺癌（NSCLC）第八版肿瘤、淋巴结、转移分类的肺叶切除术、肺段切除术和楔形切除术后的生存率。从监测、流行病学和最终结果数据库中确定因IA期NSCLC接受肺叶切除术、肺段切除术或楔形切除术的患者。采用考克斯回归模型和倾向匹配分析。根据肿瘤大小比较3组患者的总生存率（OS）和肺癌特异性生存率（LCSS）。共有16，819名患者符合我们的标准。尽管肺叶切除术的OS率优于楔形切除术，但肿瘤≤ 1.0 cm的3个治疗组患者的LCSS率无统计学差异。对于1.1 - 2.0 cm的肿瘤，肺叶切除术和肺段切除术的LCSS率无统计学差异，但两者的OS和LCSS率均优于楔形切除术。对于2.1 ~ 3.0 cm的肿瘤，肺叶切除术的OS和LCSS率优于肺段切除术或楔形切除术，但肺段切除术和楔形切除术的OS和LCSS率相似。对于1.0 cm或更小的IA期NSCLC患者，肺叶切除术、肺段切除术和楔形切除术是相当的肿瘤手术。对于1.1 - 2.0 cm的肿瘤，肺叶切除术和肺段切除术的生存率相当，但比楔形切除术的生存率更高。对于2.1至3.0 cm的肿瘤，肺叶切除术仍然是标准的手术方法;对于不适合肺叶切除术的患者，肺段切除术和楔形切除术显示出相似的生存率。(C)2018胸外科医师协会
Background. This study aimed to compare the survival rates after lobectomy, segmentectomy, and wedge resection for the eighth edition of the tumor, node, metastasis classification for stage IA non-small cell lung cancer (NSCLC).Methods. Patients who underwent lobectomy, segmentectomy, or wedge resection for stage IA NSCLC were identified from the Surveillance, Epidemiology, and End Results database. A Cox regression model and propensity-matched analysis were used. The overall survival (OS) rates and lung cancer-specific survival (LCSS) rates among the three groups were compared by tumor size.Results. A total of 16,819 patients met our criteria. Although the OS rate was better for lobectomy than for wedge resection, no statistical differences in the LCSS rate were identified among the three treatment groups of patients with tumors that were 1.0 cm or smaller. For tumors from 1.1 to 2.0 cm, lobectomy and segmentectomy showed no statistical differences in the LCSS rate, but both conferred better OS and LCSS rates than wedge resection. For tumors from 2.1 to 3.0 cm, the OS and LCSS rates were better for lobectomy than for segmentectomy or wedge resection, but similar for segmentectomy and wedge resection.Conclusions. Lobectomy, segmentectomy, and wedge resection are comparable oncologic procedures for patients with stage IA NSCLC that is 1.0 cm or smaller. For tumors from 1.1 to 2.0 cm, lobectomy and segmentectomy could lead to equivalent survival rates but showed better survival rates than that observed with wedge resection. For tumors from 2.1 to 3.0 cm, lobectomy is still the standard surgical procedure; for patients who are unsuitable candidates for lobectomy, segmentectomy and wedge resection show similar survival rates. (C) 2018 by The Society of Thoracic Surgeons