SavedAdd your journal

Journals / Uludağ Üniversitesi Tıp Fakültesi Dergisi / 2021 / Cilt: 47 - Sayı: 2

Is Left Upper Lobectomy an Overtreatment for Patients with Stage I Lung Cancer in the Left Upper Lobe? A Propensity Score-Matched Analysis.

Sol Üst Lob Evre I Akciğer Kanserli Hastalar İçin Sol Üst Lobektomi Aşırı Tedavi mi? Propensity Skor Analizi

Hüseyin MELEK
Tolga Evrim SEVİNÇ
Deniz SIĞIRLI
Ahmet Sami BAYRAM
Cengiz GEBİTEKİN
Pages
265–271
Publication Date
2021-08-01
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In particular, lingulectomy or trisegmentectomy is recommended as a standard procedure for Stage I NSCLC compared to lobectomy.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:We aim to compare the outcomes of left upper lobectomy and segmentectomy for non-small cell lung cancer (NSCLC) located at the left upper lobe.
📊
Key Findings & Data:We retrospectively reviewed the medical data of patients with NSCLC located in the left upper lobe who underwent segmentectomy or lobectomy between 1999 and 2016.
💡
Conclusion & Impact:In particular, lingulectomy or trisegmentectomy is recommended as a standard procedure for Stage I NSCLC compared to lobectomy.
🔬Design:Review & Systematic Survey
📍Scope:2016 Verileri
⚙️Variables:trisegmentektomi · lingulektomi · sol üst lobektomi

Abstract

We aim to compare the outcomes of left upper lobectomy and segmentectomy for non-small cell lung cancer (NSCLC) located at the left upper lobe. We retrospectively reviewed the medical data of patients with NSCLC located in the left upper lobe who underwent segmentectomy or lobectomy between 1999 and 2016. Segmentectomy was preferred for patients with stage I who were also eligible for lobectomy and for patients who were not eligible for lobectomy due to limited cardiopulmonary reserve. In total, 127 patients were included into the propensity score analysis by using optimal data matching algorithm. After the 1:2 matching algorithm, 90 patients were divided into two groups; group 1 segmentectomy (n=30), and group 2 lobectomy (n=60). The morbidity, mortality, long-term survival rates and prognostic factors were analyzed. Histopathological investigation revealed 57 patients as stage I [group 1 (n=18), group 2 (n= 39)], 33 patients as stage II-IV [group 1 (n=12), group 2 (n= 21)]. Morbidity rate was 37.78% (37/90) [group 1: n=11 (36.67%), group 2: n=23 (38.33%), p=1.000] along with mortality rate of 1.11% [group 1: n=1 (3.33%), group 2: n=0 (0%), p=0.333]. In stage I patients, mean Kaplan-Meier survival time was 146.09 (95%CI: 111.70-180.49) for group I and 106.99 (95%CI: 77.68-136.30) for group 2 (p=0.185). This study revealed similar outcomes for patients with early stage NSCLC located at the left upper lobe undergoing either segmentectomy or lobectomy. In particular, lingulectomy or trisegmentectomy is recommended as a standard procedure for Stage I NSCLC compared to lobectomy.

Özet

Sol üst lobda yer alan küçük hücreli dışı akciğer kanseri (KHDAK) için sol üst lobektomi ve segmentektomi sonuçlarını karşılaştırmayı amaçladık. Kliniğimizde 1999-2016 yılları arasında sol üst lob yerleşimli KHDAK nedeniyle segmentektomi veya lobektomi uygulanan hastaların verilerini retrospektif olarak inceledik. Segmentektomi; lobektomi için uygun evre I hastalar ve sınırlı kardiyopulmoner rezervi nedeniyle lobektomi için uygun olmayan hastalarda uygulandı. Toplamda 127 hasta optimal veri eşleştirme algoritması kullanılarak propensity skoru analizine dahil edildi. 1: 2 eşleştirme algoritmasından sonra 90 hasta iki gruba ayrıldı; grup 1 segmentektomi (n=30) ve grup 2 lobektomi (n=60). Morbidite, mortalite, uzun dönem sağkalım oranları ve prognostik faktörler analiz edildi. Histopatolojik incelemede 57 hasta evre I [grup 1 (n = 18), grup 2 (n = 39)], 33 hasta evre II-IV [grup 1 (n = 12), grup 2 (n = 21 )] tespit edildi. Morbidite oranı % 37.78 (37/90) [grup 1: n = 11 (% 36.67), grup 2: n = 23 (% 38.33), p = 1.000] ve mortalite oranı % 1.11 [grup 1: n = 1 (% 3.33), grup 2: n = 0 (% 0), p = 0.333] idi. Evre I hastalarda ortalama Kaplan-Meier sağkalım süresi grup 1 için 146.09 (% 95 CI: 111.70-180.49) ve grup 2 için 106.99 (% 95 CI: 77.68-136.30) idi (p = 0.185) olarak sonuçlandı. Bu çalışmada sol üst lobda segmentektomi veya lobektomi uygulanan erken evre KHDAK'li hastalar için benzer sonuçlar elde edildi. Özellikle lingulektomi veya trisegmentektomi, evre I KHDAK için lobektomiye kıyasla standart bir prosedür olarak önerilmektedir.

🔖

Cite This Article

MELEK, H., SEVİNÇ, T. E., SIĞIRLI, D., BAYRAM, A. S., GEBİTEKİN, C. (2021). Is Left Upper Lobectomy an Overtreatment for Patients with Stage I Lung Cancer in the Left Upper Lobe? A Propensity Score-Matched Analysis.. Uludağ Üniversitesi Tıp Fakültesi Dergisi, Cilt: 47 - Sayı: 2, 265–271. https://ajindex.com/articles/392812

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (10)

  1. Van Schil PE, Balduyck B, De Waele M, Hendriks JM, Hertoghs M, Lauwers P. Surgical treatment of early-stage non-small-cell lung cancer. EJC Suppl. 2013 Sep;11(2):110-22.
  2. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995;60:615-22; discussion 622-3.
  3. Sienel W, Stremmel C, Kirschbaum A, Hinterberger L, Stoelben E, Hasse J, et al Frequency of local recurrence following segmentectomy of stage IA non-small cell lung cancer is influenced by segment localisation and width of resection margins--implications for patient selection for segmentectomy. Eur J Cardiothorac Surg. 2007 Mar;31(3):522-7. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf Gossot D. Totally thoracoscopic left upper lobe tri-segmentectomy. Ann Cardiothorac Surg. 2014 Mar;3(2):197-201.
  4. Houck WV, Fuller CB, McKenna RJ Jr. Video-assisted thoracic surgery upper lobe trisegmentectomy for early-stage left apical lung cancer. Ann Thorac Surg. 2004 Nov;78(5):1858-60.
  5. Review Landreneau RJ, Normolle DP, Christie NA, Awais O, Wizorek JJ, Abbas G et al. Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage I non-small-cell lung cancer: a propensity-matched analysis. J Clin Oncol. 2014 Aug 10;32(23):2449-55.
  6. Nomori H, Okada M, editors. Illustrated Anatomical Segmentectomy for Lung Cancer. Springer 2012, ISBN 978-4-431-54143-1
  7. Okada M, Mimae T, Tsutani Y, Nakayama H, Okumura S, Yoshimura M, Miyata Y. Segmentectomy versus lobectomy for clinical stage IA lung adenocarcinoma. Ann Cardiothorac Surg. 2014 Mar;3(2):153-9
  8. Soukiasian HJ, Hong E, McKenna RJ Jr. Video-assisted thoracoscopic trisegmentectomy and left upper lobectomy provide equivalent survivals for stage IA and IB lung cancer. J Thorac Cardiovasc Surg. 2012 Sep;144(3):S23-6. Dziedzic DA, Rudzinski P, Langfort R, Orlowski T; Polish Lung Cancer Study Group (PLCSG). Risk Factors for Local and Distant Recurrence After Surgical Treatment in Patients With Non-Small-Cell Lung Cancer. Clin Lung Cancer. 2016. pii: S1525- 7304(16)00003-6.
  9. Nomori H, Mori T, Izumi Y, Kohno M, Yoshimoto K, Suzuki M. Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 non-small cell lung cancer? J Thorac Cardiovasc Surg. 2012 Apr;143(4):820-4.
  10. Zhong C, Fang W, Mao T, Yao F, Chen W, Hu D. Comparison of thoracoscopic segmentectomy and thoracoscopic lobect