Lobectomy Versus Sublobectomy in Metachronous Second Primary Lung Cancer: A Propensity Score Study

Yang, Xiaodong; Zhan, Cheng; Li, Ming; Huang, Yiwei; Zhao, Mengnan; Yang, Xinyu; Zhang, Lin; Shi, Yu; Jiang, Wei; Wang, Qun

doi:10.1016/j.athoracsur.2018.04.071

Cited by 27 publications

(34 citation statements)

References 27 publications

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“…The SEER database is a population-based tumor epidemiology database in the United States, covering about 28% of the population, including thousands of cases of lung cancers since 1973, therefore the SEER database is of great help in the study of lung cancer and other tumors (Yang et al, 2017; Yang et al, 2018). By analyzing the cases in the entire population of the SEER database, it is possible to effectively avoid the bias of the patients from the research given by a single institution.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognosis of basaloid squamous cell carcinoma of the lung: a population-based analysis

Yuan

Zhan

Huang

et al. 2019

PeerJ

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Background This study analyzed the clinical features and prognosis of basaloid squamous cell carcinoma of the lung (BSC), and constructed a nomogram to predict the prognoses of patients. Methods The information of pure BSC patients was obtained in the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Then, it was evaluated, and compared with the data of lung squamous cell carcinoma (SCC), lung large cell carcinoma (LCC) and lung adenocarcinoma (LAC) patients. Subsequently, we used univariate and multivariate analyses to investigate the independent factors related to the prognoses of patients with BSC and constructed a nomogram to verify the prognoses. Results A total of 425 patients diagnosed with BSC were enrolled. Compared with patients with SCC, LCC and LAC, the mean survival time of BSC patients was better than all of them. Compared with SCC, there were significant differences between the characteristics of grade (P < 0.001), total stage (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), M stage (P < 0.001), surgery (P < 0.001), radiotherapy (P < 0.001), and chemotherapy (P < 0.001), while BSC also had significantly different clinical characteristics from LCC and LAC. Univariate and multivariate survival analyses showed that age (P < 0.001), T stage (P < 0.001), N stage (P = 0.009), M stage (P < 0.001), and surgery (P < 0.001) were independent prognostic factors of BSC. The survival of patients undergoing lobectomy was significantly better than sublobar resection, with an OR of 0.389 (0.263–0.578). We constructed a nomogram with a C-index of 0.750 (95% confidence interval) based on the results of multivariate analysis. The calibration curves based on nomogram scores indicated that the nomogram could accurately predict the prognosis of patients. Conclusions BSC had unique clinical and prognostic features. T stage, N stage, M stage, age, and surgery were independently associated with overall survival (OS). Lobectomy was a relative ideal choice for patients with BSC. The nomogram effectively predicted the OS at 1-, 3-, and 5-years.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognosis of basaloid squamous cell carcinoma of the lung: a population-based analysis

Yuan

Zhan

Huang

et al. 2019

PeerJ

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“…Yang et al found that age, sex, tumor size, nodal stage, extent of surgery (lobectomy vs. sublobectomy), year of diagnosis, histologic type, and pathologic stage of the initial cancer were prognostic predictors of long-term survival in multiple primary lung cancer. 21 This study by Yang et al is the largest performed to date, but the proportions of anatomic/nonanatomic resections were not detailed in the sublobectomy group, preoperative lung function tests and intraoperative lymphadenectomy were not reported, and 20% of the patients in the cohort were treated for ipsilateral lesions. 20 Some previous studies focused specifically on bilateral surgery for multiple primary lung cancer, with much smaller population samples, and found no differences in survival between resection types or histologic features.…”

Section: Discussionmentioning

confidence: 95%

“…17,18,20 A recent study involving a propensity score analysis of 454 pairs of matched patients revealed better long-term survival outcomes for patients treated by bilateral lobectomy than for those treated by sublobectomy, particularly for stage I multiple primary lung cancer, following a first resection performed by lobectomy in 85% of patients, and including mostly bilateral lesions (80 vs. 20% ipsilateral). 21 However, the proportions of anatomic segmentectomy and nonanatomic sublobar resection among the interventions were unknown for the sublobectomy group. 21 Only Hattori et al have analyzed the risk factors of inhospital death (early postoperative mortality).…”

Section: Discussionmentioning

confidence: 99%

“…21 However, the proportions of anatomic segmentectomy and nonanatomic sublobar resection among the interventions were unknown for the sublobectomy group. 21 Only Hattori et al have analyzed the risk factors of inhospital death (early postoperative mortality). They identified age older than 70 years, higher tumor stage, right lower lobectomy, and bilateral lower lobectomy as factors independently associated with a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes after Contralateral Anatomic Surgical Resection in Multiple Lung Cancer

Fourdrain

Bagan

Georges

et al. 2020

Thorac Cardiovasc Surg

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Background Patients treated surgically for lung cancer may present synchronous or metachronous lung cancers. The aim of this study was to evaluate outcomes after a second contralateral anatomic surgical resection for lung cancer. Methods We performed a retrospective two-center study, based on a prospective indexed database. Included patients were treated surgically by bilateral anatomic surgical resection for a second primary lung cancer. We excluded nonanatomic resections, benign lesions, and ipsilateral second surgical resections. Results Between January 2011 and September 2018, 55 patients underwent contralateral anatomic surgical resections for lung cancer, mostly for metachronous cancers. The first surgical resection was a lobectomy in most cases (45 lobectomies: 81.8%, 9 segmentectomies: 16.4%, and 1 bilobectomy: 1.8%), and a video-assisted thoracic surgery (VATS) procedure was used in 23 cases (41.8%). The mean interval between the operations was 38 months, and lobectomy was less frequent for the second surgical resection (35 lobectomies: 63.6% and 20 segmentectomies: 36.4%), with VATS procedures performed in 41 cases (74.5%). Ninety-day mortality was 10.9% (n = 6), and 3-year survival was 77%. Risk factor analysis identified the number of resected segments during the second intervention or the total number of resected segments, extent of resection (lobectomy vs. segmentectomy), surgical approach (thoracotomy vs. VATS), tumor stage, and nodal involvement as potential prognostic factors for long-term survival. Conclusion A second contralateral anatomic surgical resection for multiple primary lung cancer is possible, with a higher early mortality rate, but acceptable long-term survival, and should be indicated for carefully selected patients.

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“…A sublobectomy is defined as the extent of resection less than a lobe either requiring dissection of sectional vascular and bronchus or not ( Fig. 1), including segmentectomy and wedge resection [13]. The patient was placed in the full lateral decubitus position under general anesthesia with selective one-lung ventilation.…”

Section: Operation Techniquesmentioning

confidence: 99%

Sublobectomy is a safe alternative for localized cavitary pulmonary tuberculosis

Yang

Zhang

Dong

et al. 2021

J Cardiothorac Surg

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Objective Surgical resection plays an essential role in the treatment of Pulmonary Tuberculosis (PTB). There are few reports comparing lobectomy and sublobectomy for pulmonary TB with cavity. To compare the advantages between lobectomy and sublobectomy for localized cavitory PTB, we performed a single-institution cross sectional cohort study of the surgical patients. Methods We consecutively included 203 patients undergoing lobectomy or sublobectomy surgery for localized cavitary PTB. All patients were followed up, recorded and compared their surgical complication, outcome and associated characteristics. Results Both groups had similar outcomes after follow up for 13.1 ± 12.1 months, however, sublobectomy group suffered fewer intraoperative blood losses, shorter length of stay, and fewer operative complications than lobectomy group (P < 0.05). Both groups obtained satisfactory outcome with postoperatively medicated for similar period of time and few relapse (P > 0.05). Conclusion Both sublobectomy and lobectomy resection were effective ways for cavitary PTB with surgical indications. If adequate anti-TB chemotherapy had been guaranteed, sublobectomy is able to be recommended due to more lung parenchyma retain, faster recover, and fewer postoperative complications.

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Lobectomy Versus Sublobectomy in Metachronous Second Primary Lung Cancer: A Propensity Score Study

Abstract: This study indicates that lobectomy is still a valid choice for MSPLC. Sublobectomy has value and shows equivalency in tumors sized 2 cm or smaller. For patients with advanced disease or at high risk, additional studies are needed to explore the value of sublobectomy.

Cited by 27 publications

References 27 publications

Clinical characteristics and prognosis of basaloid squamous cell carcinoma of the lung: a population-based analysis

Clinical characteristics and prognosis of basaloid squamous cell carcinoma of the lung: a population-based analysis

Outcomes after Contralateral Anatomic Surgical Resection in Multiple Lung Cancer

Sublobectomy is a safe alternative for localized cavitary pulmonary tuberculosis

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