Long-term results of middle lobectomy patients operated for non-small cell lung cancer.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Bahar Agaoglu Sanli, Yunus Turk, Esra Yamansavci Sirzai, Serkan Yazgan, Ahmet Ucvet
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引用次数: 0

Abstract

Objectives: Lobectomy is the most frequently performed surgical treatment for lung cancer; isolated middle lobectomy (IML) is the least frequently performed lobectomy. Until recently, IML performed for Non-Small Cell Lung Cancer (NSCLC) located in the middle lobe of the lung was considered insufficient in oncologic surgery, and upper bilobectomy (Upper lobe + Middle lobe) or lower bilobectomy (Lower lobe + Middle lobe) was performed for isolated middle lobe tumors. Since postoperative morbidity and mortality rates are worse in bilobectomy compared to lobectomy, IMLs have become frequently performed. In this study, patients who underwent IML for NSCLC were compared with upper or lower lobectomies (ULL), and the oncologic results of patients who underwent IML were evaluated.

Materials and methods: In this study, 45 patients who underwent IML at our institution between 2012 and 2022 and 45 patients, who underwent right upper or lower lobectomy and were similar in terms of gender and age, were retrospectively analyzed. Oncological outcomes between these two groups were evaluated.

Results: The mean age of 45 patients, 34 (75.6%) male and 11 (24.5%) female, who underwent IML was found to be 62.5 ± 8.4 years. According to the type of surgery, 27 (60%) patients underwent thoracotomy and 18 (40%) patients underwent Video-Assisted Thoracoscopic Surgery (VATS). When tumor histopathologies were examined in all lobectomy patients, it was seen that squamous cell carcinoma was statistically significantly more dominant in IML patients than in the other two lobectomy groups (p = 0.014). In addition, it was seen that the tumor size was smaller in IML patients than in the other groups (p = 0.005). When the survival characteristics between these two groups were evaluated, the overall survival time (OS) of patients who underwent IML was 118.0 (59.0-124.0) months, while the overall survival time of patients who underwent ULL was 71.0 (66.0-74.0) months, and no statistically significant difference was found between the groups. No statistically significant difference was observed between the groups in terms of 30-day and 90-day mortality rates and 5-year survival rates.

Conclusion: There was no significant difference in survival between patients who underwent IML for NSCLC and those who underwent same-sided ULL. Based on these results, IML can be considered as an oncologically appropriate treatment option for masses confined to the middle lobe without the need for bilobectomy.

Graphical abstract:

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-024-01886-4.

非小细胞肺癌中肺叶切除术患者的远期疗效分析。
目的:肺叶切除术是肺癌最常用的手术治疗方法;孤立性中叶切除术(IML)是最不常见的肺叶切除术。直到最近,对于位于肺中叶的非小细胞肺癌(NSCLC)行IML在肿瘤学手术中被认为是不够的,对于孤立的中叶肿瘤则行上叶切除(上叶+中叶)或下叶切除(下叶+中叶)。由于与肺叶切除术相比,胆叶切除术的术后发病率和死亡率更低,因此iml已成为经常实施的手术。在本研究中,对NSCLC患者行IML与上、下肺叶切除术(ULL)进行比较,并对行IML患者的肿瘤学结果进行评估。材料与方法:本研究回顾性分析我院2012 - 2022年间行IML的45例患者,以及45例性别、年龄相近的右上叶或右下叶切除术患者。评估两组患者的肿瘤预后。结果:行IML患者45例,男性34例(75.6%),女性11例(24.5%),平均年龄62.5±8.4岁。根据手术类型,27例(60%)患者行开胸手术,18例(40%)患者行电视胸腔镜手术(VATS)。当对所有患者进行肿瘤组织病理学检查时,IML患者中鳞状细胞癌的优势明显高于其他两组(p = 0.014)。此外,IML患者的肿瘤大小比其他组小(p = 0.005)。两组间生存特征比较,IML组患者总生存时间(OS)为118.0(59.0-124.0)个月,ULL组患者总生存时间为71.0(66.0-74.0)个月,两组间差异无统计学意义。在30天死亡率和90天死亡率以及5年生存率方面,两组间无统计学差异。结论:非小细胞肺癌行IML与同侧ULL患者的生存率无显著差异。基于这些结果,对于局限于中叶的肿块,IML可以被认为是一种肿瘤学上合适的治疗选择,而无需进行胆管切除术。图片摘要:补充信息:在线版本包含补充资料,可在10.1007/s12055-024-01886-4获得。
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
Indian Journal of Thoracic and Cardiovascular Surgery
Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.20
自引率
14.30%
发文量
141
期刊介绍: The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.
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