Erschienen in:
16.04.2016 | Original Article
Sublobar resection versus lobectomy for stage I non-small cell lung cancer: an appropriate choice in elderly patients?
verfasst von:
Alfonso Fiorelli, Francesco Paolo Caronia, Niccolò Daddi, Domenico Loizzi, Luca Ampollini, Nicoletta Ardò, Luigi Ventura, Paolo Carbognani, Rossella Potenza, Francesco Ardissone, Francesco Sollitto, Sandro Mattioli, Francesco Puma, Mario Santini, Mark Ragusa
Erschienen in:
Surgery Today
|
Ausgabe 12/2016
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Abstract
Purposes
The aim of this study was to evaluate whether sublobar resection could achieve recurrence and survival rates equivalent to lobectomy in high-risk elderly patients.
Methods
We conducted a retrospective multicenter study that including all consecutive patients (aged >75 years) who underwent operation for clinical stage I non-small cell lung cancer (NSCLC). The clinicopathological data, postoperative morbidity and mortality, recurrence rate and vital status were retrieved. The overall survival, cancer-specific survival and disease-free survival were also assessed.
Results
Two hundred and thirty-nine patients (median age 78 years) were enrolled. Lobectomies were performed in 149 (62.3 %) patients and sublobar resections in 90 (39 segmentectomies, 51 wedge resections). There were no differences in the recurrence rates following lobar versus sublobar resections (19 versus 23 %, respectively; p = 0.5) or the overall survival (p = 0.1), cancer-specific survival (p = 0.3) or disease-free survival (p = 0.1). After adjusting for 1:1 propensity score matching and a matched pair analysis, the results remained unchanged. A tumor size >2 cm and pN2 disease were independent negative prognostic factors in unmatched (p = 0.01 and p = 0.0003, respectively) and matched (p = 0.02 and p = 0.005, respectively) analyses.
Conclusions
High-risk elderly patients may benefit from sublobar resection, which provides an equivalent long-term survival compared to lobectomy.