Bo Deng1, Stephen D Cassivi2, Mariza de Andrade3, Francis C Nichols2, Victor F Trastek2, Yi Wang4, Jason A Wampfler3, Shawn M Stoddard5, Dennis A Wigle2, Robert K Shen2, Mark S Allen2, Claude Deschamps2, Ping Yang6. 1. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn; Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China. 2. Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn. 3. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn. 4. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn; School of Environmental Science and Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. 5. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn. 6. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minn. Electronic address: yang.ping@mayo.edu.
Abstract
OBJECTIVE: We compared the clinical outcomes and changes in pulmonary function test (PFT) results after segmentectomy or lobectomy for non-small cell lung cancer. METHODS: The retrospective study included 212 patients who had undergone segmentectomy (group S) and 2336 patients who had undergone lobectomy (group L) from 1997 to 2012. The follow-up and medical record data were collected. We used all the longitudinal PFT data within 24 months postoperatively and performed linear mixed modeling. We analyzed the 5-year overall and disease-free survival in stage IA patients. We used propensity score case matching to minimize the bias due to imbalanced group comparisons. RESULTS: During the perioperative period, 1 death (0.4%) in group S and 7 (0.3%) in group L occurred. The hospital stay for the 2 groups was similar (median, 5.0 vs 5.0 days; range, 2-99 vs 2-58). The mean overall and disease-free survival period of those with T1a after segmentectomy or lobectomy seemed to be similar (4.2 vs 4.5 years, P=.06; and 4.1 vs 4.4 years, P=.07, respectively). Compared with segmentectomy, lobectomy yielded marginally significantly better overall (4.4 vs 3.9 years, P=.05) and disease-free (4.1 vs 3.6 years; P=.05) survival in those with T1b. We did not find a significantly different effect on the PFTs after segmentectomy or lobectomy. CONCLUSIONS: Both surgical types were safe. We would advocate lobectomy for patients with stage IA disease, especially those with T1b. A retrospective study with a large sample size and more detailed information should be conducted for PFT evaluation, with additional stratification by lobe and laterality.
OBJECTIVE: We compared the clinical outcomes and changes in pulmonary function test (PFT) results after segmentectomy or lobectomy for non-small cell lung cancer. METHODS: The retrospective study included 212 patients who had undergone segmentectomy (group S) and 2336 patients who had undergone lobectomy (group L) from 1997 to 2012. The follow-up and medical record data were collected. We used all the longitudinal PFT data within 24 months postoperatively and performed linear mixed modeling. We analyzed the 5-year overall and disease-free survival in stage IApatients. We used propensity score case matching to minimize the bias due to imbalanced group comparisons. RESULTS: During the perioperative period, 1 death (0.4%) in group S and 7 (0.3%) in group L occurred. The hospital stay for the 2 groups was similar (median, 5.0 vs 5.0 days; range, 2-99 vs 2-58). The mean overall and disease-free survival period of those with T1a after segmentectomy or lobectomy seemed to be similar (4.2 vs 4.5 years, P=.06; and 4.1 vs 4.4 years, P=.07, respectively). Compared with segmentectomy, lobectomy yielded marginally significantly better overall (4.4 vs 3.9 years, P=.05) and disease-free (4.1 vs 3.6 years; P=.05) survival in those with T1b. We did not find a significantly different effect on the PFTs after segmentectomy or lobectomy. CONCLUSIONS: Both surgical types were safe. We would advocate lobectomy for patients with stage IA disease, especially those with T1b. A retrospective study with a large sample size and more detailed information should be conducted for PFT evaluation, with additional stratification by lobe and laterality.
Authors: Ping Yang; Mark S Allen; Marie C Aubry; Jason A Wampfler; Randolph S Marks; Eric S Edell; Stephen Thibodeau; Alex A Adjei; James Jett; Claude Deschamps Journal: Chest Date: 2005-07 Impact factor: 9.410
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