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

Chenyang Dai; Jianfei Shen; Yijiu Ren; Shengyi Zhong; Hui Zheng; Jiaxi He; Dong Xie; Ke Fei; Wenhua Liang; Gening Jiang; Ping Yang; Rene Horsleben Petersen; Calvin S H Ng; Chia-Chuan Liu; Gaetano Rocco; Alessandro Brunelli; Yaxing Shen; Chang Chen; Jianxing He

doi:10.1200/JCO.2015.64.6729

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

Chenyang Dai, Jianfei Shen, Yijiu Ren, Shengyi Zhong, Hui Zheng, Jiaxi He, Dong Xie, Ke Fei, Wenhua Liang, Gening Jiang, Ping Yang, Rene Horsleben Petersen, Calvin S H Ng, Chia-Chuan Liu, Gaetano Rocco, Alessandro Brunelli, Yaxing Shen, Chang Chen, Jianxing He

120 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	Journal of Clinical Oncology
Vol/bind	34
Udgave nummer	26
Sider (fra-til)	3175-82
ISSN	0732-183X
DOI	https://doi.org/10.1200/JCO.2015.64.6729
Status	Udgivet - 10 sep. 2016
Udgivet eksternt	Ja

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10.1200/JCO.2015.64.6729

Citationsformater

Dai, C., Shen, J., Ren, Y., Zhong, S., Zheng, H., He, J., Xie, D., Fei, K., Liang, W., Jiang, G., Yang, P., Petersen, R. H., Ng, C. S. H., Liu, C.-C., Rocco, G., Brunelli, A., Shen, Y., Chen, C., & He, J. (2016). 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. Journal of Clinical Oncology, 34(26), 3175-82. https://doi.org/10.1200/JCO.2015.64.6729

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 et al.
I: Journal of Clinical Oncology, Bind 34, Nr. 26, 10.09.2016, s. 3175-82.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Dai, C, Shen, J, Ren, Y, Zhong, S, Zheng, H, He, J, Xie, D, Fei, K, Liang, W, Jiang, G, Yang, P, Petersen, RH, Ng, CSH, Liu, C-C, Rocco, G, Brunelli, A, Shen, Y, Chen, C & He, J 2016, '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', Journal of Clinical Oncology, bind 34, nr. 26, s. 3175-82. https://doi.org/10.1200/JCO.2015.64.6729

@article{216fe85736744cbfa26644c6a1671d48,

title = "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",

abstract = "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.",

keywords = "Aged, Carcinoma, Non-Small-Cell Lung/mortality, Chi-Square Distribution, Clinical Decision-Making, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Lung Neoplasms/mortality, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Patient Selection, Pneumonectomy/adverse effects, Proportional Hazards Models, Retrospective Studies, Risk Factors, SEER Program, Time Factors, Treatment Outcome, Tumor Burden, United States",

author = "Chenyang Dai and Jianfei Shen and Yijiu Ren and Shengyi Zhong and Hui Zheng and Jiaxi He and Dong Xie and Ke Fei and Wenhua Liang and Gening Jiang and Ping Yang and Petersen, {Rene Horsleben} and Ng, {Calvin S H} and Chia-Chuan Liu and Gaetano Rocco and Alessandro Brunelli and Yaxing Shen and Chang Chen and Jianxing He",

note = "{\textcopyright} 2016 by American Society of Clinical Oncology.",

year = "2016",

month = sep,

day = "10",

doi = "10.1200/JCO.2015.64.6729",

language = "English",

volume = "34",

pages = "3175--82",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

publisher = "American Society of Clinical Oncology",

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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

PY - 2016/9/10

Y1 - 2016/9/10

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

SN - 0732-183X

VL - 34

SP - 3175

EP - 3182

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 26

ER -

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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