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Sublobar Resection for Non-Small Cell Lung Cancer in Octogenarians: A Prospective, Multicenter Study.
Mimae, Takahiro; Saji, Hisashi; Nakamura, Hiroshige; Okumura, Norihito; Tsuchida, Masanori; Sonobe, Makoto; Miyazaki, Takuro; Aokage, Keiju; Nakao, Masayuki; Haruki, Tomohiro; Okada, Morihito; Suzuki, Kenji; Yoshino, Ichiro.
Afiliação
  • Mimae T; Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan. Electronic address: tmimae@hiroshima-u.ac.jp.
  • Saji H; Department of Chest Surgery, St Marianna University School of Medicine, Kanagawa, Japan.
  • Nakamura H; Division of General Thoracic Surgery, Tottori University Hospital, Tottori, Japan.
  • Okumura N; Department of Thoracic Surgery, Kurashiki Central Hospital, Okayama, Japan.
  • Tsuchida M; Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  • Sonobe M; Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
  • Miyazaki T; Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Aokage K; Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Nakao M; Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
  • Haruki T; Division of General Thoracic Surgery, Tottori University Hospital, Tottori, Japan.
  • Okada M; Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan; Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Kyoto, Japan.
  • Suzuki K; Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Kyoto, Japan; Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
  • Yoshino I; Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan; The Japanese Association for Chest Surgery, Kyoto, Japan.
Ann Thorac Surg ; 116(3): 543-551, 2023 09.
Article em En | MEDLINE | ID: mdl-37004802
BACKGROUND: Segmentectomy is a good surgical option for peripheral, early, non-small cell lung cancer (NSCLC) ≤2 cm. However, the role of sublobar resection including wedge resection and segmentectomy remains unclear for octogenarians with >2-cm but ≤4-cm early-stage NSCLC, for which lobectomy is a standard treatment. METHODS: By use of a prospective registry, 892 patients aged ≥80 years with operable lung cancer were enrolled at 82 institutions. Of these, we analyzed the clinicopathologic findings and surgical outcomes of 419 patients with NSCLC tumors of 2 to 4 cm during a median follow-up of 50.9 months between April 2015 and December 2016. RESULTS: Five-year overall survival (OS) was slightly but not significantly worse after sublobar resection than after lobectomy in the entire cohort (54.7% [95% CI, 43.2%-93.0%] vs 66.8% [95% CI, 60.8%-72.1%]; P = .09). Multivariable Cox regression analysis of OS revealed that these surgical procedures were not independent prognostic predictors (hazard ratio, 0.8 [0.5-1.1]; P = .16). The 5-year OS was comparable between 192 patients who could tolerate lobectomy but were treated by sublobar resection or lobectomy (67.5% [95% CI, 48.8%-80.6%] vs 71.5% [95% CI, 62.9%-78.4%]; P = .79). Recurrence after sublobar resection and lobectomy was locoregional in 11 (11%) of 97 and in 23 (7%) of 322 patients, respectively. CONCLUSIONS: OS might be equivalent between sublobar resection with a secure surgical margin and lobectomy for selected patients aged ≥80 years with peripheral early-stage NSCLC tumors of 2 to 4 cm who can tolerate lobectomy.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Carcinoma de Pequenas Células do Pulmão / Neoplasias Pulmonares Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged80 / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Carcinoma de Pequenas Células do Pulmão / Neoplasias Pulmonares Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged80 / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article