{"title":"对于处于中心位置的临床i期非小细胞肺癌,肺叶切除术比叶下切除术更可取。","authors":"Satoshi Takamori, Marina Nakatsuka, Hikaru Watanabe, Jun Suzuki, Makoto Endo, Satoshi Shiono","doi":"10.1093/ejcts/ezaf233","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Tumour location can affect clinicians' decisions regarding the surgical procedure, especially when choosing between lobectomy and segmentectomy. The biological behaviour of clinical stage I non-small cell lung cancer (NSCLC) may differ based on tumour location. We aimed to explore the biological behaviour of centrally located (CL) clinical stage I NSCLC and to identify which surgical procedure is more appropriate for such tumours.</p><p><strong>Methods: </strong>This retrospective study included 719 patients who underwent curative operations for stage I NSCLC between April 2004 and December 2023. The biological behaviour of the tumours was analysed based on tumour location. Overall and recurrence-free survivals in patients who underwent lobectomy or more extensive procedures, including hilar and mediastinal lymph node dissection, were assessed based on tumour location.</p><p><strong>Results: </strong>A total of 124 (17.2%) and 595 (82.8%) patients were included in the CL and peripherally located groups, respectively. The CL group had a significantly higher standardized uptake value maximum on positron emission tomography/computed tomography, a higher-grade adenocarcinoma subtype, and a higher frequency of lymph node metastasis than the peripherally located group. In multivariable analysis, CL and radiologically pure solid tumours (consolidation/tumour ratio = 1) were significant factors for occult lymph node metastasis. No significant difference was observed in survival based on tumour location.</p><p><strong>Conclusions: </strong>Centrally located clinical stage I NSCLCs tend to be hypermetabolic and have a potential risk of lymph node metastasis. Lobectomy could be a better treatment option for CL clinical stage I NSCLC.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312707/pdf/","citationCount":"0","resultStr":"{\"title\":\"Lobectomy is the preferred choice rather than sublobar resection for centrally located clinical stage 1 non-small cell lung cancer.\",\"authors\":\"Satoshi Takamori, Marina Nakatsuka, Hikaru Watanabe, Jun Suzuki, Makoto Endo, Satoshi Shiono\",\"doi\":\"10.1093/ejcts/ezaf233\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Tumour location can affect clinicians' decisions regarding the surgical procedure, especially when choosing between lobectomy and segmentectomy. The biological behaviour of clinical stage I non-small cell lung cancer (NSCLC) may differ based on tumour location. We aimed to explore the biological behaviour of centrally located (CL) clinical stage I NSCLC and to identify which surgical procedure is more appropriate for such tumours.</p><p><strong>Methods: </strong>This retrospective study included 719 patients who underwent curative operations for stage I NSCLC between April 2004 and December 2023. The biological behaviour of the tumours was analysed based on tumour location. Overall and recurrence-free survivals in patients who underwent lobectomy or more extensive procedures, including hilar and mediastinal lymph node dissection, were assessed based on tumour location.</p><p><strong>Results: </strong>A total of 124 (17.2%) and 595 (82.8%) patients were included in the CL and peripherally located groups, respectively. The CL group had a significantly higher standardized uptake value maximum on positron emission tomography/computed tomography, a higher-grade adenocarcinoma subtype, and a higher frequency of lymph node metastasis than the peripherally located group. In multivariable analysis, CL and radiologically pure solid tumours (consolidation/tumour ratio = 1) were significant factors for occult lymph node metastasis. No significant difference was observed in survival based on tumour location.</p><p><strong>Conclusions: </strong>Centrally located clinical stage I NSCLCs tend to be hypermetabolic and have a potential risk of lymph node metastasis. Lobectomy could be a better treatment option for CL clinical stage I NSCLC.</p>\",\"PeriodicalId\":520617,\"journal\":{\"name\":\"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312707/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ejcts/ezaf233\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ejcts/ezaf233","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Lobectomy is the preferred choice rather than sublobar resection for centrally located clinical stage 1 non-small cell lung cancer.
Objectives: Tumour location can affect clinicians' decisions regarding the surgical procedure, especially when choosing between lobectomy and segmentectomy. The biological behaviour of clinical stage I non-small cell lung cancer (NSCLC) may differ based on tumour location. We aimed to explore the biological behaviour of centrally located (CL) clinical stage I NSCLC and to identify which surgical procedure is more appropriate for such tumours.
Methods: This retrospective study included 719 patients who underwent curative operations for stage I NSCLC between April 2004 and December 2023. The biological behaviour of the tumours was analysed based on tumour location. Overall and recurrence-free survivals in patients who underwent lobectomy or more extensive procedures, including hilar and mediastinal lymph node dissection, were assessed based on tumour location.
Results: A total of 124 (17.2%) and 595 (82.8%) patients were included in the CL and peripherally located groups, respectively. The CL group had a significantly higher standardized uptake value maximum on positron emission tomography/computed tomography, a higher-grade adenocarcinoma subtype, and a higher frequency of lymph node metastasis than the peripherally located group. In multivariable analysis, CL and radiologically pure solid tumours (consolidation/tumour ratio = 1) were significant factors for occult lymph node metastasis. No significant difference was observed in survival based on tumour location.
Conclusions: Centrally located clinical stage I NSCLCs tend to be hypermetabolic and have a potential risk of lymph node metastasis. Lobectomy could be a better treatment option for CL clinical stage I NSCLC.