Prospective cohort study of Suture-Line recurrence and clinical outcomes in stage 1A Non-Small cell lung cancer

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-03-01 DOI:10.1016/j.lungcan.2025.108465

Louis Gros , Rowena Yip , Raja M. Flores , Jiafang Zhang , Natela Paksashvili , Lijing Zhang , Lyu Lyu , Siyang Cai , Emanuela Taioli , David F. Yankelevitz , Claudia I. Henschke , for the IELCART Investigators

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引用次数: 0

Abstract

Background

Increased lung cancer screening has made early-stage non-small-cell lung cancer (NSCLC) more common, with lung-sparing surgery as the standard curative treatment. Our study evaluated patients who underwent surgery for pathologic stage 0/1A NSCLC and presented with suture-line recurrences—either isolated or with additional findings—and compared these patients to other types of recurrence.

Methods

We analyzed 653 patients with pathologic stage 0/1A NSCLC from the IELCART cohort (2016–2023). Recurrences were categorized by the presence or absence of suture line involvement, and survival outcomes were assessed.

Findings

Among 653 patients (median age 69), 44 (11.3 %) experienced recurrences, including 22 suture-line recurrences. Sublobar resections (19/22 vs. 11/22, p = 0.01) and smaller margins (8 mm vs. 20 mm, p < 0.001) were more frequent in patients with suture-line recurrences. Of the 22 suture-line recurrences, 13 were isolated, and 9 had additional findings. Isolated recurrences were diagnosed later (31.0 vs. 14.0 months, p = 0.01) and treated with surgery (6/13) or radiotherapy (7/13), both well-tolerated. Patients with isolated suture-line recurrences demonstrated better survival outcomes compared to all other recurrence types (overall survival: 72.0 % vs. 45.7 %, p = 0.02; lung cancer-specific survival: 90.0 % vs. 76.1 %, p = 0.19).

Interpretation

Recurrences after stage 0/1A lung cancer surgery are rare, with half involving the suture line. Suture-line recurrences arise around two years post-surgery, often following sublobar resections with resection margins under 1 cm. For isolated suture-line recurrences, treatment with either radiotherapy and completion surgery were effective, yielding comparable outcomes and improved survival compared to any other recurrence types.

Abstract Image

查看原文本刊更多论文

1A期非小细胞肺癌缝合线复发和临床结果的前瞻性队列研究

肺癌筛查的增加使得早期非小细胞肺癌（NSCLC）更加常见，保留肺手术成为标准的治疗方法。我们的研究评估了接受手术治疗病理期0/1A NSCLC的患者，并将这些患者与其他类型的复发进行了比较。方法我们分析了来自IELCART队列（2016-2023）的653例病理期0/1A NSCLC患者。根据是否累及缝合线对复发进行分类，并评估生存结果。结果：在653例患者（中位年龄69岁）中，44例（11.3%）复发，包括22例缝线复发。叶下切除（19/22 vs 11/22, p = 0.01）和较小的切缘(8 mm vs 20 mm, p <；0.001)在缝线复发患者中更为常见。在22例缝线复发中，13例是孤立的，9例有其他发现。孤立性复发诊断较晚（31.0个月vs 14.0个月，p = 0.01），接受手术（6/13）或放疗（7/13）治疗，均耐受良好。与所有其他复发类型相比，孤立缝线复发的患者表现出更好的生存结果(总生存率：72.0%对45.7%,p = 0.02；肺癌特异性生存率：90.0% vs. 76.1%, p = 0.19)。结论：0/1A期肺癌手术后复发是罕见的，其中一半累及缝合线。缝合线复发发生在手术后两年左右，通常是在切除边缘小于1cm的叶下切除术后。对于孤立的缝合线复发，放疗和手术完成治疗都是有效的，与任何其他复发类型相比，结果相当，生存率提高。

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

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.