Choice of Surgical Procedure for Patients With Non-Small-Cell Lung Cancer ≤ 1 cm or > 1 to 2 cm Among Lobectomy, Segmentectomy, and Wedge Resection: A Population-Based Study
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Choice of Surgical Procedure for Patients With Non-Small-Cell Lung Cancer ≤ 1 cm or > 1 to 2 cm Among Lobectomy, Segmentectomy, and Wedge Resection : A Population-Based Study. / Dai, Chenyang; Shen, Jianfei; Ren, Yijiu; Zhong, Shengyi; Zheng, Hui; He, Jiaxi; Xie, Dong; Fei, Ke; Liang, Wenhua; Jiang, Gening; Yang, Ping; Petersen, Rene Horsleben; Ng, Calvin S H; Liu, Chia-Chuan; Rocco, Gaetano; Brunelli, Alessandro; Shen, Yaxing; Chen, Chang; He, Jianxing.
In: Journal of Clinical Oncology, Vol. 34, No. 26, 2016, p. 3175-82.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Choice of Surgical Procedure for Patients With Non-Small-Cell Lung Cancer ≤ 1 cm or > 1 to 2 cm Among Lobectomy, Segmentectomy, and Wedge Resection
T2 - A Population-Based Study
AU - Dai, Chenyang
AU - Shen, Jianfei
AU - Ren, Yijiu
AU - Zhong, Shengyi
AU - Zheng, Hui
AU - He, Jiaxi
AU - Xie, Dong
AU - Fei, Ke
AU - Liang, Wenhua
AU - Jiang, Gening
AU - Yang, Ping
AU - Petersen, Rene Horsleben
AU - Ng, Calvin S H
AU - Liu, Chia-Chuan
AU - Rocco, Gaetano
AU - Brunelli, Alessandro
AU - Shen, Yaxing
AU - Chen, Chang
AU - He, Jianxing
N1 - © 2016 by American Society of Clinical Oncology.
PY - 2016
Y1 - 2016
N2 - PURPOSE: According to the lung cancer staging project, T1a (≤ 2 cm) non-small-cell lung cancer (NSCLC) should be additionally classified into ≤ 1 cm and > 1 to 2 cm groups. This study aimed to investigate the surgical procedure for NSCLC ≤ 1 cm and > 1 to 2 cm.METHODS: We identified 15,760 patients with T1aN0M0 NSCLC after surgery from the Surveillance, Epidemiology, and End Results database. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among patients after lobectomy, segmentectomy, or wedge resection. The proportional hazards model was applied to evaluate multiple prognostic factors.RESULTS: OS and LCSS favored lobectomy compared with segmentectomy or wedge resection in patients with NSCLC ≤ 1 cm and > 1 to 2 cm. Multivariable analysis showed that segmentectomy and wedge resection were independently associated with poorer OS and LCSS than lobectomy for NSCLC ≤ 1 cm and > 1 to 2 cm. With sublobar resection, lower OS and LCSS emerged for NSCLC > 1 to 2 cm after wedge resection, whereas similar survivals were observed for NSCLC ≤ 1 cm. Multivariable analyses showed that wedge resection is an independent risk factor of survival for NSCLC > 1 to 2 cm but not for NSCLC ≤ 1 cm.CONCLUSION: Lobectomy showed better survival than sublobar resection for patients with NSCLC ≤ 1 cm and > 1 to 2 cm. For patients in whom lobectomy is unsuitable, segmentectomy should be recommended for NSCLC > 1 to 2 cm, whereas surgeons could rely on surgical skills and the patient profile to decide between segmentectomy and wedge resection for NSCLC ≤ 1 cm.
AB - PURPOSE: According to the lung cancer staging project, T1a (≤ 2 cm) non-small-cell lung cancer (NSCLC) should be additionally classified into ≤ 1 cm and > 1 to 2 cm groups. This study aimed to investigate the surgical procedure for NSCLC ≤ 1 cm and > 1 to 2 cm.METHODS: We identified 15,760 patients with T1aN0M0 NSCLC after surgery from the Surveillance, Epidemiology, and End Results database. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among patients after lobectomy, segmentectomy, or wedge resection. The proportional hazards model was applied to evaluate multiple prognostic factors.RESULTS: OS and LCSS favored lobectomy compared with segmentectomy or wedge resection in patients with NSCLC ≤ 1 cm and > 1 to 2 cm. Multivariable analysis showed that segmentectomy and wedge resection were independently associated with poorer OS and LCSS than lobectomy for NSCLC ≤ 1 cm and > 1 to 2 cm. With sublobar resection, lower OS and LCSS emerged for NSCLC > 1 to 2 cm after wedge resection, whereas similar survivals were observed for NSCLC ≤ 1 cm. Multivariable analyses showed that wedge resection is an independent risk factor of survival for NSCLC > 1 to 2 cm but not for NSCLC ≤ 1 cm.CONCLUSION: Lobectomy showed better survival than sublobar resection for patients with NSCLC ≤ 1 cm and > 1 to 2 cm. For patients in whom lobectomy is unsuitable, segmentectomy should be recommended for NSCLC > 1 to 2 cm, whereas surgeons could rely on surgical skills and the patient profile to decide between segmentectomy and wedge resection for NSCLC ≤ 1 cm.
KW - Aged
KW - Carcinoma, Non-Small-Cell Lung/mortality
KW - Chi-Square Distribution
KW - Clinical Decision-Making
KW - Disease-Free Survival
KW - Female
KW - Humans
KW - Kaplan-Meier Estimate
KW - Lung Neoplasms/mortality
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Neoplasm Staging
KW - Patient Selection
KW - Pneumonectomy/adverse effects
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - Risk Factors
KW - SEER Program
KW - Time Factors
KW - Treatment Outcome
KW - Tumor Burden
KW - United States
U2 - 10.1200/JCO.2015.64.6729
DO - 10.1200/JCO.2015.64.6729
M3 - Journal article
C2 - 27382092
VL - 34
SP - 3175
EP - 3182
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 26
ER -
ID: 226259587