Outcomes and Survival for Early-Stage Non-Small Cell Lung Cancer Following Wedge Resection or Lobectomy: A Propensity Score-Matched Analysis Using a Novel Peruvian Registry.
J Chest Surg
; 2024 Aug 08.
Article
en En
| MEDLINE
| ID: mdl-39115200
ABSTRACT
Background:
Using a previously unreported Peruvian registry of patients treated for early-stage non-small cell lung cancer (NSCLC), this study explored whether wedge resection and lobectomy were equivalent regarding survival and impact on radiologic-pathologic variables.Methods:
This observational, analytical, longitudinal study used propensity score-matched (PSM) analysis of a single-center retrospective registry of 2,570 patients with pathologic stage I-II NSCLC who were treated with wedge resection (n=1,845) or lobectomy (n=725) during 2000-2020. After PSM, 650 cases were analyzed (resection, n=325; lobectomy, n=325) through preoperative and clinical variables, including patients with ≥1 lymph node removed. Kaplan-Meier curves and multivariable Cox proportional hazard models were created for 5-year overall survival (OS), disease-free survival (DFS), and locoregional-recurrence-free survival (LRFS).Results:
The principal complication was operative pain persisting >7 days for lobectomy versus wedge resection (58% vs. 23%, p=0.034) and shorter hospital stays for resection than for lobectomy (5.3 days vs. 12.8 days, p=0.009). The 5-year OS (84.3% vs. 81.2%, p=0.09) and DFS (79.1% vs. 74.1%, p=0.07) were similar and statistically insignificant between resections and lobectomies, respectively. LRFS was worse overall following wedge resection than lobectomy (79.8% vs. 91.1%, p<0.02). Nevertheless, in the PSM analysis, both groups experienced similar LRFS when the resection margin was >10 mm (90.9% vs. 87.3%, p<0.048) and ≥4 lymph nodes were removed (82.8% vs. 79.1%, p<0.011).Conclusion:
Both techniques led to similar OS and DFS at 5 years; however, successful LRFS required a wedge resection with a surgical margin and adequate lymph node removal to obtain outcomes similar to lobectomy.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Chest Surg
Año:
2024
Tipo del documento:
Article
País de afiliación:
Perú