In:
Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 50, No. 9 ( 2020-09-05), p. 1051-1057
Abstract:
Anatomical resection with lymph node dissection is the standard treatment for early non–small cell lung cancer, whereas wedge resection is considered as a compromise. We aimed to determine whether wedge resection without lymph node dissection could be a treatment option for patients aged ≥80 years. Methods We assessed 669 patients with clinical stage IA non–small cell lung cancer, whole tumour sizes ≤2 cm and a consolidation to tumour ratio of & gt;0.5 who underwent R0 resection at three institutions between 2010 and 2016. We selected 58 of them who were aged ≥80 years and analysed their clinicopathological findings and prognosis after surgical procedures over a median follow-up of 38 months. Propensity scores for surgical procedures were calculated using age, gender, smoking status and solid tumour size on computed tomography. Results Three-year overall and recurrence-free survival rates after wedge resection and after segmentectomy + lobectomy for patients aged ≥80 years did not significantly differ (overall survival: 88.9% [95% confidence interval, 69.4–96.3%] vs. 75.5% [95% confidence interval, 51.5–88.8%] , P = 0.95; recurrence-free survival: 85.2% [95% confidence interval: 65.2–94.2%] vs. 68.0% [95% confidence interval, 44.4–83.2] , P = 0.57). Multivariable Cox regression analysis of overall survival with propensity scores revealed that surgical procedure was not an independent predictor of a poor prognosis (hazard ratio: 0.86 (0.28–2.6), P = 0.78) in patients aged ≥80 years. Conclusions Wedge resection might be an alternative to lobectomy or segmentectomy with lymph node dissection for patients aged ≥80 years with early non–small cell lung cancer.
Type of Medium:
Online Resource
ISSN:
1465-3621
DOI:
10.1093/jjco/hyaa085
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2020
detail.hit.zdb_id:
1494610-5
