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Asian Cardiovasc Thorac Ann. 2013 Oct;21(5):566-73. doi: 10.1177/0218492312466861. Epub 2013 Jul 11.

Wedge resection verses lobectomy for stage 1 non-small-cell lung cancer.

Author information

1
Liverpool Heart and Chest Hospital, Liverpool, UK.

Abstract

BACKGROUND:

Lobectomy remains the gold standard with regard to potentially curative resection of non-small-cell lung carcinoma. We aimed to investigate whether there is a survival difference in stage 1 non-small-cell lung cancer patients who undergo lobectomy compared to a wedge resection.

METHODS:

We retrospectively analyzed a prospective database of 1283 patients who had potentially curative resection for stage 1 non-small-cell lung cancer. Only patients with adenocarcinoma, squamous or adenosquamous carcinoma were included. We benchmarked our 5-year survival against the 6th International Association for the Study of Lung Cancer results. Three techniques were used to assess the effect of a lobectomy compared to a wedge resection with regard to long-term survival: Cox multivariate regression analysis, neuronal network analysis, and propensity matching.

RESULTS:

Benchmarking failed to reveal any significant difference compared to the 6th International Association for the Study of Lung Cancer results. Crude analysis demonstrated superiority of lobectomy compared to wedge resection, p = 0.02. Cox regression analysis confirmed that age, body mass index, female sex, being a current smoker, tumor diameter, and preoperative forced expiratory volume in 1 s were all significant factors determining long-term survival. Wedge resection was not a significant factor. Neuronal network analysis concurred with the Cox regression analysis. Propensity matching with 1:1 matching demonstrated that wedge resections was not inferior to a lobectomy, p = 0.10.

CONCLUSIONS:

Cox regression analysis, neuronal network analysis, and propensity matching in stage 1 non-small-cell lung cancer demonstrate no difference in long-term survival after wedge resection compared to lobectomy.

KEYWORDS:

Carcinoma; lung neoplasms; non-small-cell lung; pneumonectomy; survival rate; treatment outcome

PMID:
24570559
DOI:
10.1177/0218492312466861
[Indexed for MEDLINE]

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