Erschienen in:
14.06.2017 | Original Article – Clinical Oncology
The indication of completion lobectomy for lung adenocarcinoma ≤3 cm after wedge resection during surgical operation
verfasst von:
Yiyang Wang, Rui Wang, Difan Zheng, Baohui Han, Jie Zhang, Heng Zhao, Jizhuang Luo, Jiajie Zheng, Tianxiang Chen, Qingyuan Huang, Yihua Sun, Haiquan Chen
Erschienen in:
Journal of Cancer Research and Clinical Oncology
|
Ausgabe 10/2017
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Abstract
Purpose
This retrospective study was designed to find out the potential indications of completion lobectomy (CL) during wedge resection (WR) operation among patients with lung adenocarcinoma (ADC) ≤3 cm, by the use of Shanghai Chest Hospital Lung Cancer Database.
Patients and methods
There were totally 1938 patients in this study, including 746 WRs and 1192 CLs. The propensity score matching (PSM) was performed to minimize the effect of confounders. Univariable and multivariable cox regressions were analyzed to discover the independent risk factors of recurrence-free survival (RFS) and overall survival (OS). Subgroup analysis and Kaplan–Meier survival curves were performed if necessary.
Results
The 5-year RFS (86.1 vs 91.5%, p = 0.001 for unmatched group; 84 v 92%, p < 0.001 for PSM group) and OS (83.6 vs 91.7%, p < 0.001 for unmatched group; 81.6 vs 88.2%, p < 0.001 for PSM group) all indicated a better prognosis when conducting CL. Subgroup analysis suggested that WR was appropriate for non-invasive ADC. Three prognostic factors (sex, surgical approach and pleural invasion) were correlated with RFS and two (sex and surgical approach) corresponded with OS in invasive ADC through multivariable analysis. Non-lepidic-predominant component showed a better RFS and OS when CL was operated after WR in the subgroup of invasive ADC.
Conclusion
CL was an appropriate remediation to WR when the existence of invasive ADC, especially non-lepidic-predominant one. While WR could be applied if non-invasive ADC was confirmed. Whether lepidic-predominant adenocarcinoma was fit for WR needed further study.