Comparison of survivals between sublobar resection and lobar resection for patients with clinical stage I non‐small cell lung cancer and interstitial lung disease: a propensity score matching analysis

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2024-09-09 DOI:10.1111/1759-7714.15418

Ryohei Matsushima, Kosuke Fujino, Yamato Motooka, Hiroyuki Yamada, Chika Shirakami, Yusuke Shinchi, Hironobu Osumi, Tatsuya Yamada, Kentaro Yoshimoto, Koei Ikeda, Ichiro Kubota, Makoto Suzuki

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Abstract

BackgroundPatients with early‐stage lung cancer and interstitial lung disease have a poorer prognosis than those without interstitial lung disease. This study aimed to compare the long‐term outcomes of lobar and sublobar resections in these patients.MethodsWe retrospectively analyzed 138 consecutive patients with clinical stage I non‐small cell lung cancer and interstitial lung disease who underwent surgical treatment at two institutions between January 2010 and December 2020. Propensity score matching analysis was performed to adjust for baseline characteristics.ResultsThirty‐six patients underwent sublobar resection and 102 underwent lobar resection. The median follow‐up was 45.7 months. In all patients, 5‐year overall survival (OS) rates were 33.2% and 73.2%, and 5‐year recurrence‐free survival (RFS) rates were 24.2% and 60.1% in the sublobar and lobar resection groups, respectively (p < 0.01, <0.01). Death due to lung cancer and locoregional recurrence were significantly more frequent in the sublobar resection group than in the lobar resection group (p = 0.034, <0.01, respectively). On propensity score matching analysis, the 5‐year OS rates of the 19 matched pairs were 46.3% and 73.2%, and the RFS rates were 31.6% and 67.6% in the sublobar and lobar resection groups, respectively (p = 0.036, <0.01). The Cox proportional hazards model demonstrated a significant association between lobar resection and improved survival (p = 0.047).ConclusionThe patients in the lobar resection group had better survival rates than those in the sublobar resection group. In terms of long‐term prognosis, deliberately limited surgery may not be necessary for patients who tolerate lobectomy.

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临床 I 期非小细胞肺癌合并间质性肺病患者叶下切除术和叶状切除术的生存率比较：倾向得分匹配分析

背景早期肺癌合并间质性肺病患者的预后比无间质性肺病患者差。方法我们回顾性分析了2010年1月至2020年12月期间在两家机构接受手术治疗的138例临床I期非小细胞肺癌合并间质性肺疾病的连续患者。结果36名患者接受了叶下切除术，102名患者接受了肺叶切除术。中位随访时间为 45.7 个月。在所有患者中，叶下切除组和叶上切除组的5年总生存率（OS）分别为33.2%和73.2%，5年无复发生存率（RFS）分别为24.2%和60.1%（p <0.01，<0.01）。肺叶下切除组因肺癌死亡和局部区域复发的频率明显高于肺叶切除组（p = 0.034，<0.01，分别为0.034和<0.01）。根据倾向得分匹配分析，19 对匹配对的 5 年 OS 率分别为 46.3% 和 73.2%，叶下切除组和叶上切除组的 RFS 率分别为 31.6% 和 67.6%（p = 0.036，<0.01）。Cox比例危险模型显示，肺叶切除与生存率提高之间存在显著关联（p = 0.047）。就长期预后而言，对于能够耐受肺叶切除术的患者而言，可能不需要刻意进行限制性手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.