Sublobectomy versus lobectomy for peripheral small-sized pulmonary mucinous adenocarcinoma.

IF 2.1 3区医学 Q3 RESPIRATORY SYSTEM

Journal of thoracic disease Pub Date : 2025-01-24 Epub Date: 2025-01-22 DOI:10.21037/jtd-2024-2096

Zhen Yang, Fujun Yang, Zhaoxun Li, Hiran C Fernando, Xiang Li, Gening Jiang, Xiao Song

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引用次数: 0

Abstract

Background: Pulmonary mucinous adenocarcinoma (PMA), a rare type of adenocarcinoma, remains controversial in terms of its associated prognosis. We conducted this study to compare the oncological outcomes of lobectomy and sublobectomy for peripheral small-sized PMA.

Methods: This retrospective observational study included all patients with peripheral small-sized (≤2 cm) clinical stage IA1-A2 PMA who underwent lobectomy or sublobectomy (with margin distances ≥2 cm or greater than tumor diameter) between January 2015 and December 2018. Recurrence-free survival (RFS) and overall survival (OS) were compared between the lobectomy and sublobectomy groups with Kaplan-Meier curves and log-rank tests.

Results: This study examined 279 patients, with 176 cases in the lobectomy group and 103 cases in the sublobectomy group. Recurrence occurred in 8 patients, and 6 patients died. Before and after propensity score matching (PSM), log-rank tests showed no statistical differences between the lobectomy and sublobectomy groups in terms of 5-year RFS (before PSM: 97.0% vs. 98.9%; after PSM: 94.6% vs. 98.9%) or 5-year OS (before PSM: 96.9% vs. 98.8%; after PSM: 94.8% vs. 98.8%), and the recurrence patterns were also similar between the two groups. The incidence of postoperative complications, such as bronchopleural fistula, hydrothorax requiring redrainage, chylothorax, respiratory failure, and pulmonary embolism, also did not differ between the two groups.

Conclusions: For peripheral small-sized PMA, sublobectomy yielded an RFS and OS comparable to those of lobectomy.

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肺叶下切除术与肺叶切除术治疗周围性小型肺粘液腺癌。

背景：肺粘液腺癌（PMA）是一种罕见的腺癌，其预后仍存在争议。我们进行了这项研究，以比较肺叶切除术和肺叶亚切除术治疗周围性小型PMA的肿瘤学结果。方法：本回顾性观察研究纳入2015年1月至2018年12月期间接受肺叶切除术或叶下切除术（边缘距离≥2cm或大于肿瘤直径）的所有外周血小尺寸（≤2cm）临床分期IA1-A2 PMA患者。采用Kaplan-Meier曲线和log-rank检验比较肺叶切除术组和亚肺叶切除术组的无复发生存期（RFS）和总生存期（OS）。结果：本研究共检查279例患者，其中肺叶切除术组176例，肺叶亚切除术组103例。复发8例，死亡6例。倾向评分匹配（PSM）前后，对数秩检验显示，肺叶切除术组和亚肺叶切除术组在5年RFS方面无统计学差异(PSM前：97.0% vs. 98.9%；PSM后：94.6% vs. 98.9%)或5年OS (PSM前：96.9% vs. 98.8%；PSM后（94.8% vs. 98.8%），两组复发模式相似。术后并发症的发生率，如支气管胸膜瘘、需要再引流的胸水、乳糜胸、呼吸衰竭和肺栓塞，在两组之间也没有差异。结论：对于外周小尺寸PMA，肺叶亚切除术的RFS和OS与肺叶切除术相当。

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

Journal of thoracic disease RESPIRATORY SYSTEM-

CiteScore

4.60

自引率

4.00%

发文量

254

期刊介绍： The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.