Stage I non-small-cell lung cancer: long-term results of lobectomy versus sublobar resection from the Polish National Lung Cancer Registry†

Dziedzic, Robert; Żurek, Wojciech; Marjański, Tomasz; Rudziński, Piotr; Orłowski, T; Sawicka, Wioletta; Marczyk, Michał; Polańska, Joanna; Rzyman, Witold

doi:10.1093/ejcts/ezx092

Cited by 67 publications

(55 citation statements)

References 16 publications

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“…Figure a illustrates the predicted five year survival rate after lobectomy. Outcomes from real studies are marked by gray dots . In real studies, the median age of each cohort was set to a representative value of age at diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…Lobectomy is undoubtedly the standard of care for operable early‐stage NSCLC in the current situation where there are no randomized trials comparing SABR with lobectomy. However, most of the previously reported studies on lobectomy included young patients with an average age of 65 years, while those on SABR included older patients with an average age of 75 years . As a result, it is difficult to compare the overall survival between the two procedures directly using the existing research designs including patients of different age distributions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lobectomy versus stereotactic ablative radiotherapy for medically operable patients with stage IA non‐small cell lung cancer: A virtual randomized phase III trial stratified by age

Seo

Kim

et al. 2019

Thoracic Cancer

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Background Although the choice between stereotactic ablative radiotherapy ( SABR) and lobectomy for early‐stage non‐small cell lung cancer (NSCLC) has been debated for years, the two procedures have not yet been directly compared in a randomized trial. We conducted a virtual randomized phase III trial stratified by age to compare the effectiveness of lobectomy and SABR for medically operable patients with stage IA (AJCC eighth) NSCLC using the Markov model analysis. Methods A Markov model was developed to simulate a cohort of patients aged 45–85 years with stage IA NSCLC who had undergone either lobectomy or SABR and were followed up for their remaining lifetime. Each virtual patient was randomly assigned to undergo lobectomy or SABR, and 10 000 patients were allocated to each group. All estimates of the variables were obtained by a systematic review of published articles. Results The lobectomy group showed a better life expectancy than the SABR group, in patients under 75 years of age. However, no statistically significant difference was seen in patients 75 years or older. The predicted life expectancy was 9.43 and 8.70 years in 75‐year‐old patients in the lobectomy and SABR groups, respectively. However, the 95%CI for the difference in life expectancy between the two groups was ‐ 0.06–1.50 years ( P = 0.0689). Conclusions The Markov model showed no statistically significant difference in the expected overall survival in stage IA NSCLC patients who were older than 75 years and had undergone SABR or lobectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lobectomy versus stereotactic ablative radiotherapy for medically operable patients with stage IA non‐small cell lung cancer: A virtual randomized phase III trial stratified by age

Seo

Kim

et al. 2019

Thoracic Cancer

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“…Lobectomy combined with systematic lymph node (LN) dissection or sampling currently is the treatment of choice for patients with NSCLC. However, increasing evidence has emerged from institutional case series and national registry to Original Article Appropriate lymphadenectomy significantly reduced recurrence after segmentectomy for patients with non-small cell lung cancer support the equivalency in the long-term survival between segmentectomy and lobectomy for small-sized earlystage NSCLC (2)(3)(4)(5)(6). Segmentectomy is chosen for the well-selected patients, for its advantage of preserving lung parenchyma, pulmonary function and a chance of future resections for secondary primary lung cancer (7).…”

Section: Introductionmentioning

confidence: 99%

Appropriate lymphadenectomy significantly reduced recurrence after segmentectomy for patients with non-small cell lung cancer

Wang¹,

Gu²,

Pan³

et al. 2018

J. Thorac. Dis.

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Background: Segmentectomy has been widely used for small-sized non-small cell lung cancer (NSCLC).The objective of this study is to determine the impact of number of harvested lymph nodes (LNs) on survival for patients undergoing segmentectomy. Methods: The clinicopathologic data of patients undergoing segmentectomy for NSCLC from July 2011 to December 2014 were retrospectively analyzed. Survival analysis was performed by Kaplan-Meier method and Cox regression analysis. Results: A total of 259 patients with NSCLC were eligible for analysis. Patients with harvested LN ≥6 had higher frequency of nodal metastasis in pathologic examination (9.4% vs. 1.5%, P=0.005). The 3-year recurrence-free survival (RFS) of patients with harvested LN ≥6 (90.2%) was significantly higher than that of patients with harvested LN <6 (73.7%, log-rank P=0.038). Multivariable Cox analysis identified harvested LN ≥6 as an independent predictor for improved RFS [hazard ratio (HR) =0.35; 95% confidence interval (CI): 0.14-0.90; P=0.029]. There was no significant difference in RFS between patients with harvested LN station ≥3 and <3 (log-rank P=0.34). Conclusions: The number of harvest LN ≥6 was independently associated with improved RFS for NSCLC patients undergoing segmentectomy, supporting the National Comprehensive Cancer Network (NCCN) guidelines of appropriate LN sampling.

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“…In several observational studies, lobectomy and segmentectomy has shown comparable long-term outcomes in stage I NSCLC less than 2 cm in diameter (3,4). Most of the studies shows similar outcomes in lobectomy and sublobar resection but there are contradictory results when wedge resection and segmentectomy are analyzed separately.…”

mentioning

confidence: 99%

“…According to Altorki et al a wedge resection and segmentectomy is associated with comparable outcome for patients with small cT1N0 NSCLC (5). In retrospective observational study of Dziedzic et al, which assessed the results of treatment of stage I NSCLC, wedge resection was associated with significantly worse five-year survival rate compared to lobectomy and segmentectomy (4). What may be the difference between wedge and segmental resection is the resection margin and hilar and mediastinal…”

mentioning

confidence: 99%

Stage I non-small-cell lung cancer: long-term results of lobectomy versus sublobar resection from the Polish National Lung Cancer Registry†

Cited by 67 publications

References 16 publications

Lobectomy versus stereotactic ablative radiotherapy for medically operable patients with stage IA non‐small cell lung cancer: A virtual randomized phase III trial stratified by age

Lobectomy versus stereotactic ablative radiotherapy for medically operable patients with stage IA non‐small cell lung cancer: A virtual randomized phase III trial stratified by age

Appropriate lymphadenectomy significantly reduced recurrence after segmentectomy for patients with non-small cell lung cancer

The role of sublobar resections in the treatment of early stage non-small cell lung cancer—still awaiting evidence

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