Yiyang Wang1, Rui Wang1, Difan Zheng2, Baohui Han3, Jie Zhang4, Heng Zhao1, Jizhuang Luo1, Jiajie Zheng1, Tianxiang Chen1, Qingyuan Huang1, Yihua Sun2, Haiquan Chen5,6,7. 1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China. 3. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 4. Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 5. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China. hqchen1@yahoo.com. 6. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. hqchen1@yahoo.com. 7. Institutes of Biomedical Sciences, Fudan University, Shanghai, China. hqchen1@yahoo.com.
Abstract
PURPOSE: This retrospective study was designed to find out the potential indications of completion lobectomy (CL) during wedge resection (WR) operation among patients with lung adenocarcinoma (ADC) ≤3 cm, by the use of Shanghai Chest Hospital Lung Cancer Database. PATIENTS AND METHODS: There were totally 1938 patients in this study, including 746 WRs and 1192 CLs. The propensity score matching (PSM) was performed to minimize the effect of confounders. Univariable and multivariable cox regressions were analyzed to discover the independent risk factors of recurrence-free survival (RFS) and overall survival (OS). Subgroup analysis and Kaplan-Meier survival curves were performed if necessary. RESULTS: The 5-year RFS (86.1 vs 91.5%, p = 0.001 for unmatched group; 84 v 92%, p < 0.001 for PSM group) and OS (83.6 vs 91.7%, p < 0.001 for unmatched group; 81.6 vs 88.2%, p < 0.001 for PSM group) all indicated a better prognosis when conducting CL. Subgroup analysis suggested that WR was appropriate for non-invasive ADC. Three prognostic factors (sex, surgical approach and pleural invasion) were correlated with RFS and two (sex and surgical approach) corresponded with OS in invasive ADC through multivariable analysis. Non-lepidic-predominant component showed a better RFS and OS when CL was operated after WR in the subgroup of invasive ADC. CONCLUSION: CL was an appropriate remediation to WR when the existence of invasive ADC, especially non-lepidic-predominant one. While WR could be applied if non-invasive ADC was confirmed. Whether lepidic-predominant adenocarcinoma was fit for WR needed further study.
PURPOSE: This retrospective study was designed to find out the potential indications of completion lobectomy (CL) during wedge resection (WR) operation among patients with lung adenocarcinoma (ADC) ≤3 cm, by the use of Shanghai Chest Hospital Lung Cancer Database. PATIENTS AND METHODS: There were totally 1938 patients in this study, including 746 WRs and 1192 CLs. The propensity score matching (PSM) was performed to minimize the effect of confounders. Univariable and multivariable cox regressions were analyzed to discover the independent risk factors of recurrence-free survival (RFS) and overall survival (OS). Subgroup analysis and Kaplan-Meier survival curves were performed if necessary. RESULTS: The 5-year RFS (86.1 vs 91.5%, p = 0.001 for unmatched group; 84 v 92%, p < 0.001 for PSM group) and OS (83.6 vs 91.7%, p < 0.001 for unmatched group; 81.6 vs 88.2%, p < 0.001 for PSM group) all indicated a better prognosis when conducting CL. Subgroup analysis suggested that WR was appropriate for non-invasive ADC. Three prognostic factors (sex, surgical approach and pleural invasion) were correlated with RFS and two (sex and surgical approach) corresponded with OS in invasive ADC through multivariable analysis. Non-lepidic-predominant component showed a better RFS and OS when CL was operated after WR in the subgroup of invasive ADC. CONCLUSION: CL was an appropriate remediation to WR when the existence of invasive ADC, especially non-lepidic-predominant one. While WR could be applied if non-invasive ADC was confirmed. Whether lepidic-predominant adenocarcinoma was fit for WR needed further study.
Authors: Rodney J Landreneau; Daniel P Normolle; Neil A Christie; Omar Awais; Joseph J Wizorek; Ghulam Abbas; Arjun Pennathur; Manisha Shende; Benny Weksler; James D Luketich; Matthew J Schuchert Journal: J Clin Oncol Date: 2014-06-30 Impact factor: 44.544
Authors: Frank C Detterbeck; Sandra Zelman Lewis; Rebecca Diekemper; Doreen Addrizzo-Harris; W Michael Alberts Journal: Chest Date: 2013-05 Impact factor: 9.410
Authors: Jong Ho Cho; Yong Soo Choi; Jhingook Kim; Hong Kwan Kim; Jae Ill Zo; Young Mog Shim Journal: Ann Thorac Surg Date: 2014-11-15 Impact factor: 4.330
Authors: Rajwanth R Veluswamy; Nicole Ezer; Grace Mhango; Emily Goodman; Marcelo Bonomi; Alfred I Neugut; Scott Swanson; Charles A Powell; Mary B Beasley; Juan P Wisnivesky Journal: J Clin Oncol Date: 2015-08-03 Impact factor: 44.544
Authors: Benedikt H Heidinger; Ursula Schwarz-Nemec; Kevin R Anderson; Constance de Margerie-Mellon; Antonio C Monteiro Filho; Yigu Chen; Marius E Mayerhoefer; Paul A VanderLaan; Alexander A Bankier Journal: Radiol Cardiothorac Imaging Date: 2019-08-29
Authors: Waseem Lutfi; Matthew J Schuchert; Rajeev Dhupar; Chigozirim Ekeke; Inderpal S Sarkaria; Neil A Christie; James D Luketich; Olugbenga T Okusanya Journal: Clin Lung Cancer Date: 2019-04-01 Impact factor: 4.785