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Anatomic resection has superior long-term survival compared with wedge resection for second primary lung cancer after prior lobectomy
- Source :
- European Journal of Cardio-Thoracic Surgery. 59:1014-1020
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- OBJECTIVES The extent of surgical resection for early-stage second primary lung cancer (SPLC) in patients with a previous lobectomy is unclear. We sought to compare anatomic lung resections (lobectomy and segmentectomy) and wedge resections for small peripheral SPLC using a population-based database. METHODS The Surveillance, Epidemiology and End Results database was queried for all patients with ≤2 cm peripheral SPLC diagnosed between 2004 and 2015 who underwent prior lobectomy for the first primary and surgical resection only for the SPLC. American College of Chest Physicians guidelines were used to classify SPLC. Kaplan–Meier analysis and multivariable Cox regression were used to compare overall survival. RESULTS A total of 356 patients met the inclusion criteria with 203 (57%) treated with wedge resection and 153 (43%) treated with anatomic resection. Significantly better median survival was observed with anatomic resection than with wedge resection using a Kaplan–Meier analysis (124 vs 63 months; P CONCLUSIONS Anatomic resections may provide better long-term survival than wedge resections for patients with early-stage peripheral SPLC after prior lobectomy. Significant improvement in survival was observed with wedge resection for SPLC when adequate lymph node dissection was performed.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Lung Neoplasms
Population
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Carcinoma, Non-Small-Cell Lung
medicine
Humans
Pneumonectomy
Lung cancer
education
Lung
Lymph node
Neoplasm Staging
education.field_of_study
business.industry
Proportional hazards model
Hazard ratio
General Medicine
medicine.disease
Confidence interval
Surgery
Dissection
medicine.anatomical_structure
030220 oncology & carcinogenesis
Cardiology and Cardiovascular Medicine
business
SEER Program
Wedge resection (lung)
Subjects
Details
- ISSN :
- 1873734X and 10107940
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....90d6bd42345aa06e6755c66ded0f0699