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。

Satoshi Takamori, Marina Nakatsuka, Hikaru Watanabe, Jun Suzuki, Makoto Endo, Satoshi Shiono
{"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}
引用次数: 0

摘要

目的:肿瘤的位置可以影响临床医生对手术的决定,特别是在选择肺叶切除术和节段切除术时。临床I期非小细胞肺癌的生物学行为可能因肿瘤位置而异。我们的目的是探讨中心位置临床I期非小细胞肺癌的生物学行为,并确定哪种外科手术更适合这种肿瘤。方法:本回顾性研究包括2004年4月至2023年12月期间接受I期非小细胞肺癌手术治疗的719例患者。根据肿瘤的位置分析肿瘤的生物学行为。接受肺叶切除术或更广泛手术(包括肺门和纵隔淋巴结清扫)的患者的总体生存率和无复发生存率根据肿瘤位置进行评估。结果:中心位组124例(17.2%),外周位组595例(82.8%)。中心位置组在正电子发射断层扫描/计算机断层扫描上的标准化摄取值最大值明显高于周围位置组,腺癌亚型的分级更高,淋巴结转移的频率也更高。在多变量分析中,中心位置和放射学上纯粹的实体瘤(实变/肿瘤比= 1)是隐匿性淋巴结转移的重要因素。肿瘤位置不同,生存率无显著差异。结论:位于中心位置的临床I期非小细胞肺癌倾向于高代谢,具有淋巴结转移的潜在风险。肺叶切除术可能是中心位置临床I期非小细胞肺癌的较好治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信