Impact of Central Airway Infiltration Type in Primary Lung Cancer Patients Treated With Sleeve Lobectomy

Abstract

Background/Aim: There are two types of lung cancer cell infiltration into the central airway. One is when a centrally located lung cancer directly infiltrates the central airway and the other is when cancer cells in the metastatic hilar lymph node infiltrate the central airway. We aimed to identify the impact of central airway infiltration type on the clinical features of patients undergoing sleeve lobectomy. Patients and Methods: The clinical courses of 58 primary lung cancer patients who underwent sleeve lobectomy between January 2010 and December 2020 were investigated. Results: Primary tumors directly infiltrated into the central airway in 42 patients, whereas 16 patients had infiltration of cancer cells from the metastatic hilar lymph node. Primary tumor infiltration was a poor prognostic factor according to both univariate (p=0.016) and multivariate analyses (p=0.042). Operation times (p=0.240) and incidences of adverse events (p=0.926) were not associated with the type of central airway infiltration. Conclusion: The type of airway infiltration was an independent poor prognostic factor after sleeve lobectomy in primary lung cancer patients. Our findings may guide the selection of optimal treatments for this patient population.There are two ways in which lung cancer cells infiltrate into the central airway. One involves a centrally located lung cancer directly infiltrating the central airway. The other is when cancer cells in the metastatic hilar lymph node infiltrate the central airway. Sleeve lobectomy is required to completely remove centrally located lung cancers or lung cancers with hilar lymph node metastasis and to preserve the peripheral lung tissue. The impacts of central airway infiltration type on surgical methods, postoperative courses, and prognosis in patients undergoing sleeve lobectomy have never been investigated.This study aimed to identify the impact of central airway infiltration type on the clinical features and outcomes of patients undergoing sleeve lobectomy.