Abstract

 

OBJECTIVES

To demonstrate the differences in clinical outcomes between lobectomy and segmentectomy for non-small cell lung cancer using propensity score matching.

METHODS

A single-centre, retrospective, matched cohort study was conducted in clinical T1N0M0 non-small cell lung cancer patients treated by surgery between 2012 and 2019. Differences in freedom from recurrence, overall survival, postoperative complications, chest drainage and preservation of pulmonary function between lobectomy and segmentectomy were evaluated using the propensity score model. Matched variables of patients were age, sex, comorbidity index and pulmonary function. Matched variables of tumours were tumour size, T-stage, fluorodeoxyglucose uptake on positron emission tomography, histopathology, lobe site and tumour distance ratio from the hilum.

RESULTS

Of the 112 patients treated by lobectomy and 233 patients treated by segmentectomy, 93 patients each from both groups were selected after the matching. The median tumour distance ratio from hilum was 0.7 in lobectomy and 0.8 in segmentectomy group (P = 0.59), i.e. almost outer third tumour location. There were no significant differences in freedom from recurrence (P = 0.38), overall survival (P = 0.51), postoperative complications (P = 0.94), drainage period (P = 0.53) and prolonged air leakage (P = 0.82) between the two. Median preservation of pulmonary function was 93.2% after segmentectomy, which was significantly higher than 85.9% after lobectomy (P < 0.001).

CONCLUSIONS

Freedom from recurrence, overall survival, postoperative complications and chest drainage were similar between segmentectomy and lobectomy. Segmentectomy could be one of the options for clinical T1N0M0 non-small cell lung cancer located outer third as well as being able to preserve pulmonary function better than lobectomy.

Clinical trial registration

• Name: Retrospective analysis of segmentectomy and lobectomy for cT1N0M0 non-small cell lung cancer
• Date of approval: February 2014
• Number of IRB approval: 14-003.

中文翻译：

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肺叶切除术与肺段切除术：术后并发症、肺功能和预后的倾向评分匹配比较

摘要

 

目标

使用倾向评分匹配证明非小细胞肺癌肺叶切除术和肺段切除术在临床结果上的差异。

方法

对 2012 年至 2019 年接受手术治疗的临床 T1N0M0 非小细胞肺癌患者进行了一项单中心、回顾性、匹配的队列研究。使用倾向评分模型评估肺叶切除术和肺段切除术。患者的匹配变量是年龄、性别、合并症指数和肺功能。肿瘤的匹配变量是肿瘤大小、T 分期、正电子发射断层扫描上的氟脱氧葡萄糖摄取、组织病理学、肺叶部位和肿瘤与肺门的距离比。

结果

经肺叶切除术治疗的112例患者和肺段切除术治疗的233例患者中，匹配后选择两组各93例患者。肺叶切除组与肺门的中位肿瘤距离比为0.7，肺段切除组为0.8（P  =0.59），即几乎位于外三分之一的肿瘤位置。两者在无复发率（P  = 0.38）、总生存期（P  = 0.51）、术后并发症（P  = 0.94）、引流期（P  = 0.53）和漏气时间（P  = 0.82）方面无显着差异. 肺段切除术后肺功能的中位保留率为 93.2%，显着高于肺叶切除术后的 85.9%（P < 0.001)。

结论

肺段切除术和肺叶切除术的复发率、总生存期、术后并发症和胸腔引流相似。肺段切除术可能是位于外三分之一的临床 T1N0M0 非小细胞肺癌的选择之一，并且能够比肺叶切除术更好地保留肺功能。

临床试验注册

• 名称：cT1N0M0非小细胞肺癌肺段切除和肺叶切除的回顾性分析
• 批准日期：2014年2月
• IRB 批准数：14-003。