Evaluation of segmentectomy in patients with early primary lung invasive adenocarcinoma

doi:10.3877/cma.j.issn.1674-6902.2019.04.014

Abstract

Abstract:

Objective

To compare the prognostic effect of segmentectomy and lobectomy for the patients with early primary lung invasive adenocarcinoma (PLIA).

Methods

Hospital Information System (HIS) was used to identify the patients who underwent sublobar resection or lobectomy for PLIA with 0-2 cm in size. Propensity score-matching (PSM) was used to adjust the potential confounding. The Kaplan-Meier method was used to assess the overall survival (OS) and lung cancer-specific survival (LCSS).

Results

In this study, 154 patients were obtained from HIS, of whom 31 patients underwent segmentectomy and 123 underwent lobectomy. The prognosis of underwent segmentectomy was equivalent to underwent lobectomy in terms of 3-year OS (OS: HR, 1.29 (0.13-12.81), P=0.81). 10 cases of postoperative complications in these patients, 1 case (3.2%) had continuous air leakage (over 7 d) in underwent segmentectomy. 9 cases(7.3%) in underwent lobectomy, 2 cases of continuous air leakage, 1 case of pulmonary infection, 2 cases of subcutaneous emphysema, 1 case of pleural effusion. Based on age, sex, smoking history, chronic history, tumor size and number of lymph node dissection, analysis of tendentious matching to obtain 28 cases of lung segment resection and lobectomy. And segmentectomy is similar to lobectomy after the PSM (OS: HR, 2.50 (0.12-52.20), P=0.38).

Conclusion

Segmentectomy can be considered as an alternative choice for the patients with PLIA.

Key words: Adenocarcinoma of lung, Invasive adenocarcinoma, Segmentectomy, Pneumonectomy

Qiang Wu, Xiaolin Wang, Shoujian Li, Qingwen Liu, Guiwang Tang, Shichun Lu, Yusheng Shu. Evaluation of segmentectomy in patients with early primary lung invasive adenocarcinoma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(04): 473-477.

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Figures/Tables 3

References 22

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临床资料		肺段切除(n＝31)	肺叶切除(n＝123)	P值
临床资料		肺段切除(n＝31)	肺叶切除(n＝123)	PSM值	PSM^a
年龄[a(±s)]		55.2±11.0	57.7±9.4	0.21	0.95
男性(%)		16(51.6)	54(43.9)	0.28	1
吸烟史(%)		15(48.4)	54(43.9)	0.82	1
肿瘤大小≤1 cm(%)		13(41.9)	13(10.7)	<0.001	0.57
慢性病史(%)		1(3.2)	45(36.6)	0.4	1
术前CT表现
	亚实性结节	31	103	0.01	无
	实性结节	0	20
N1站淋巴结清扫				0.008	无
	(0～10)(%)	31(100)	102(82.9)
	>10(%)	0(0)	21(17.1)
N2站淋巴结清扫				<0.001	无
	(0～10)(%)	31(100)	79(64.2)
	>10(%)	0(0)	44(35.8)

临床资料		肺段切除(n＝31)	肺叶切除(n＝123)	P值
临床资料		肺段切除(n＝31)	肺叶切除(n＝123)	PSM值	PSM^a
年龄[a(±s)]		55.2±11.0	57.7±9.4	0.21	0.95
男性(%)		16(51.6)	54(43.9)	0.28	1
吸烟史(%)		15(48.4)	54(43.9)	0.82	1
肿瘤大小≤1 cm(%)		13(41.9)	13(10.7)	<0.001	0.57
慢性病史(%)		1(3.2)	45(36.6)	0.4	1
术前CT表现
	亚实性结节	31	103	0.01	无
	实性结节	0	20
N1站淋巴结清扫				0.008	无
	(0～10)(%)	31(100)	102(82.9)
	>10(%)	0(0)	21(17.1)
N2站淋巴结清扫				<0.001	无
	(0～10)(%)	31(100)	79(64.2)
	>10(%)	0(0)	44(35.8)

伴随疾病或既往病史	肺段切除(31)	肺叶切除(123)
高血压	0(0)	34(27.64)
糖尿病	0(0)	5(4.07)
冠心病	0(0)	2(1.63)
室性早搏	0(0)	1(0.81)
心房纤颤	0(0)	1(0.81)
脑缺血或脑梗死	0(0)	4(3.25)
慢性支气管炎	1(3.2)	0(0)
支气管哮喘	0(0)	1(0.81)
肝硬化	0(0)	1(0.81)
肺结核	1(3.2)	3(2.44)
良性肿瘤	0(0)	7(5.69)
鼻息肉	0(0)	2(1.63)

伴随疾病或既往病史	肺段切除(31)	肺叶切除(123)
高血压	0(0)	34(27.64)
糖尿病	0(0)	5(4.07)
冠心病	0(0)	2(1.63)
室性早搏	0(0)	1(0.81)
心房纤颤	0(0)	1(0.81)
脑缺血或脑梗死	0(0)	4(3.25)
慢性支气管炎	1(3.2)	0(0)
支气管哮喘	0(0)	1(0.81)
肝硬化	0(0)	1(0.81)
肺结核	1(3.2)	3(2.44)
良性肿瘤	0(0)	7(5.69)
鼻息肉	0(0)	2(1.63)

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