Lobectomy Is Not Associated With Improved Survival as Compared to Segmentectomy in Early-Stage Lung Cancer Patients With Visceral Pleural Invasion

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer Pub Date : 2024-11-18 DOI:10.1016/j.cllc.2024.11.007

Gregory L. Whitehorn , Hamza Rshaidat , Isheeta Madeka , Jonathan Martin , Shale J. Mack , Luke Meredith , Sneha Alaparthi , Tyler R. Grenda , Nathaniel R. Evans III , Olugbenga T. Okusanya

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Abstract

Objective

The purpose of this study is to utilize a representative national sample to compare survival outcomes of patients with visceral pleural invasion (VPI) who underwent either a lobectomy or a segmentectomy.

Methods

National Cancer Database from 2010 to 2019 was utilized. Patients with tumor size ≤ 2 cm, with VPI, non–small cell lung cancer (NSCLC), with a known vital status were included in the study. A propensity match analysis was performed to compare VPI patients undergoing either lobectomy or segmentectomy.

Results

Of the 66,181 patients who met the inclusion criteria, 6,575 (9.9%) had VPI. In postmatch analysis, there was no significant difference in 5-year survival in patients whose cancer had VPI and underwent either lobectomy or segmentectomy (76 [77.1%] vs. 71 [65.7%]; P = .23). Patients who underwent lobectomy and had VPI had poorer 5-year survival compared to patients who underwent a lobectomy and did not have VPI (1,154 [73.7%] vs. 1,240 [78.5%]; P < .001). There was no difference in 5-year survival between patients who underwent a segmentectomy and had VPI and patients who underwent a segmentectomy and did not have VPI (71 [65.7%] vs. 79 [71.0%]; P = .36).

Conclusion

A lobectomy was not associated with improved survival as compared to patients who underwent a segmentectomy in patients with early-stage NSCLC with VPI. VPI remains a poor prognostic factor for survival regardless of the procedure performed. This data would indicate that the presence of VPI should not be a determining factor in the anatomic lung resection selected in patients with small, early-stage NSCLC.

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与节段切除术相比，肺叶切除术与早期肺癌内脏胸膜侵犯患者的生存率提高无关。

目的：本研究的目的是利用一个具有代表性的国家样本来比较接受肺叶切除术或节段切除术的内脏胸膜侵犯（VPI）患者的生存结果。方法：利用2010 - 2019年国家癌症数据库。肿瘤大小≤2cm，伴有VPI，生命状态已知的非小细胞肺癌（NSCLC）患者纳入研究。进行倾向匹配分析，比较接受肺叶切除术或节段切除术的VPI患者。结果：在符合纳入标准的66181例患者中，6575例（9.9%）有VPI。在配对后分析中，患有VPI并接受肺叶切除术或节段切除术的患者的5年生存率无显著差异(76例[77.1%]vs. 71例[65.7%]；P = .23)。接受肺叶切除术并有VPI的患者与接受肺叶切除术但没有VPI的患者相比，5年生存率较差(1154[73.7%]对1240 [78.5%]；P < 0.001)。行节段切除术并有VPI的患者与行节段切除术但没有VPI的患者的5年生存率无差异(71例[65.7%]vs. 79例[71.0%]；P = .36)。结论：与早期NSCLC合并VPI患者行节段切除术相比，肺叶切除术与生存率的提高无关。无论采用何种手术，VPI仍然是预后不良的生存因素。这一数据表明，在小的早期NSCLC患者中，VPI的存在不应该是选择解剖性肺切除术的决定因素。

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

Clinical lung cancer 医学-肿瘤学

CiteScore

7.00

自引率

2.80%

发文量

159

审稿时长

24 days

期刊介绍： Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.