Sleeve lobectomy versus pneumonectomy for non-small cell lung cancer: a meta-analysis

Shi, Woda; Zhang, Wei; Sun, Haoliang; Shao, Yongfeng

doi:10.1186/1477-7819-10-265

Cited by 59 publications

(49 citation statements)

References 23 publications

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“…In order to retain greater respiratory function, when the tumor only invades the intermediate bronchus without invading the middle lobe bronchus and parenchyma, the surgeon can choose sleeve resection to retain the middle lobe . However, more than a quarter of patients in this study with LN metastasis, especially those with N2 LN metastasis, had metastatic tumor cells left in the middle lobe, thus radical resection cannot be achieved.…”

Section: Discussionmentioning

confidence: 99%

Blind spot in lung cancer lymph node metastasis: Cross‐lobe peripheral lymph node metastasis in early stage patients

Tan

et al. 2018

Thoracic Cancer

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BackgroundAt present, it has not yet been determined whether metastasis can be transferred cross‐lobe to peripheral lymph nodes (LNs) from other lobes in early stages of lung cancer, especially without any direct involvement to the pleura and parenchyma of the lobe. This study was conducted to investigate this issue.MethodsA retrospective analysis was conducted at the Chinese Academy of Medical Sciences. Patients undergoing right middle and lower lobectomy with lymphadenectomy for preoperative clinical stage Ia–IIIa from 2014 to 2015 were identified. To avoid interference, cases were limited to tumors within the primary lobe. When a tumor is completely located in the lower lobe, no direct invasion occurs into the visceral pleura/bronchus/parenchyma of the middle lobe and tumor cell metastasis into the peripheral LNs (stations 12–14) in the middle lobe is defined as cross‐lobe lymph node metastasis (CLM).ResultsA total of 68 patients were identified, of which nine (13.2%) had CLM. Seven had squamous cell carcinoma, one adenocarcinoma, and one small cell carcinoma. Seven cases (77.8%) had intermediate bronchus invasion, and seven cases (77.8%) intermediate bronchus adjacent lymph node involvement (station 11). Compared to non‐CLM patients, tumor diameter (5.2 vs. 3.2; P = 0.28), N2 lymph node metastasis rate (66.7% vs. 28.8%; P = 0.03), late stage (IIIa 77.8% vs. 35.6%; P = 0.04), and invasion of intermediate bronchus (77.8% vs. 45.8%; P = 0.07) relatively increased.ConclusionNon‐primary lobe peripheral LN metastasis exists in lung cancer and requires greater attention and further study.

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Section: Discussionmentioning

confidence: 99%

Blind spot in lung cancer lymph node metastasis: Cross‐lobe peripheral lymph node metastasis in early stage patients

Tan

et al. 2018

Thoracic Cancer

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“…For central lung cancer patients, SR is preferred by thoracic surgeons for preserving lung function, better postoperative life quality and survival . A recent meta‐analysis also showed that SR was more suitable for lower rates of mortality and better prognoses. Unlike these reports, Kim et al .…”

Section: Discussionmentioning

confidence: 99%

Comparison of short and long‐term results between sleeve resection and pneumonectomy in lung cancer patients over 70 years old: 10 years experience from a single institution in China

Pan

Tantai

et al. 2014

Thoracic Cancer

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Background: The aim of this study was to compare the short and long-term results between sleeve resection (SR) and pneumonectomy (PN) in lung cancer patients over 70 years of age. Methods: We retrospectively reviewed 105 lung cancer patients over 70 years of age who had undergone SR or PN at Shanghai Chest Hospital from January 2003 to December 2012. Results:The SR group showed a higher frequency of airway clearance via bronchoscopy (48.6% vs. 25.7%, P = 0.04), longer surgical time (162.7 vs. 140.9 minutes, P = 0.01), and shorter postoperative stay (13.7 vs. 18.1 days, P = 0.02) than the PN group. There was no difference in hospital mortality (P = 1.00) or morbidity (P = 0.40) between the two groups. A logistic regression model showed that preoperative predicted forced expiratory volume in 1 second was the only independent risk factor for overall morbidity (P = 0.04). In survival analysis, SR showed better prognosis than PN (median 50.0 vs. 20.0 months, P < 0.01). In subgroup analysis, SR showed better survival in N0 (P = 0.03) and N1 (P < 0.01) cases, but not in N2 cases (P = 0.36). It also showed better survival in stage I + II patients (P = 0.03), but not in stage III patients (P = 0.10). Conclusions: Although PN could be carried out as safely as SR in patients over 70 years of age with a good pulmonary reservoir, SR is still recommended as a less traumatic procedure, sparing lung parenchyma with better long-term results.

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“…Die 30-Tage-Mortalität nach Pneumonektomie liegt je nach Literatur bei 6-13,3%, im Gegensatz zur Lobektomie bei nichtkleinzelligem Bronchialkarzinom mit 2,9-4% [21,25]. Im Vergleich zu anderen Organresektionen in der Tumoronkologie, beispielsweise der Gastrektomie oder der Operation nach Whipple mit einer perioperativen Mortalität von <5%, weist die Pneumonektomie eine hohe perioperative Mortalität auf.…”

Section: Folgen In Der Frühphaseunclassified

“…Aufgrund der höheren Lebensqualität sowie des besseren Langzeitüberlebens der Patienten nach Manschettenlobektomie sollten, falls onkologisch vertretbar, parenchymsparende Eingriffe der Pneumonektomie vorgezogen werden [12,25]. Um dieses Ziel zu erreichen, sollten gegebenenfalls neoadjuvante multimodale Verfahrenskonzepte zum Downstaging angewandt werden.…”

Section: Lebensqualität Nach Pneumonektomieunclassified

Folgen der Pneumonektomie in der Früh- und Spätphase

Hatz

Klotz

2013

Chirurg

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Pneumonectomy can represent the appropriate surgical treatment option in advanced or centrally localized non-small cell lung cancer (NSCLC). A satisfactory oncologic tumor surgery can be reached in these cases although pneumonectomy is associated with a significantly higher mortality and morbidity than less extensive resection of the lung parenchyma.The aim of this article is a systematic review and the presentation of possible postoperative consequences of pneumonectomy in the early and late phases, which depend not only on the underlying disease but are also primarily affected by the state and function of the remaining contralateral lung parenchyma. Cardiopulmonary complications, especially pneumonia, pulmonary embolism, cardiac arrhythmia or myocardial infarction lead to increased 30-day mortality in the early postoperative period. Moreover, advanced ages over 70 years can be identified as a significant risk factor for poor quality of life after pneumonectomy.

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Sleeve lobectomy versus pneumonectomy for non-small cell lung cancer: a meta-analysis

Cited by 59 publications

References 23 publications

Blind spot in lung cancer lymph node metastasis: Cross‐lobe peripheral lymph node metastasis in early stage patients

Blind spot in lung cancer lymph node metastasis: Cross‐lobe peripheral lymph node metastasis in early stage patients

Comparison of short and long‐term results between sleeve resection and pneumonectomy in lung cancer patients over 70 years old: 10 years experience from a single institution in China

Folgen der Pneumonektomie in der Früh- und Spätphase

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