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Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma.
- Source :
-
European Journal of Cardio-Thoracic Surgery . Jul2024, Vol. 66 Issue 1, p1-9. 9p. - Publication Year :
- 2024
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Abstract
- OBJECTIVES To determine safety and survival outcomes associated with lobectomy, segmentectomy and wedge resection for early-stage lung cancer by quiring the French population-based registry EPIdemiology in THORacic surgery (EPITHOR). METHODS Retrospective analysis of 19 452 patients with stage c IA lung carcinoma who underwent lobectomy, segmentectomy or wedge resection between 2016 and 2022 with curative-intent. Main outcome measures were 90-day mortality and 5-year overall survival estimates. Proportional hazards regression and propensity score matching were used to adjust outcomes for key patient, tumour and practice environment factors. RESULTS The treatment distribution was 72.2% for lobectomy, 21.5% for segmentectomy and 6.3% for wedge. Unadjusted 90-day mortality rates were 1.6%, 1.2% and 1.1%, respectively (P = 0.10). Unadjusted 5-year overall survival estimates were 80%, 78% and 70%, with significant inter-group survival curves differences (P < 0.0001). Multivariable proportional hazards regression showed that wedge was associated with worse overall survival [adjusted hazard ratio (AHR), 1.23 (95% confidence interval 1.03–1.47); P = 0.021] compared with lobectomy, while no significant difference was disclosed when comparing segmentectomy to lobectomy (1.08 [0.97–1.20]; P = 0.162). The three-way propensity score analyses confirmed similar 90-day mortality rate for wedge resection and segmentectomy compared with lobectomy (hazard ratio: 0.43; 95% confidence interval 0.16–1.11; P = 0.081 and 0.99; 0.48–2.10; P = 0.998, respectively), but poorer overall survival (1.45; 1.13–1.86; P = 0.003 and 1.31; 1–1.71; P = 0.048, respectively). CONCLUSIONS Wedge resection was associated with comparable 90-day mortality but lower overall survival when compared to lobectomy. Overall, all types of sublobar resections may not offer equivalent oncologic effectiveness in real-world settings. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10107940
- Volume :
- 66
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 178738713
- Full Text :
- https://doi.org/10.1093/ejcts/ezae251