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Int J Surg. 2017 Jan;37:1-7. doi: 10.1016/j.ijsu.2016.11.090. Epub 2016 Nov 24.

Sublobectomy versus lobectomy for stage I non-small cell lung cancer in the elderly.

Author information

1
Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Oncology, Shandong University Qilu Hospital, Shandong University, #107 West Wenhua Road, Jinan 250010, PR China.
2
Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
3
Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Thoracic Surgery, Jining First People's Hospital of Shandong Province, #6 Health Road, Jining 272111, PR China.
4
Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
5
Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China.
6
Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China; Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, #324 Jingwu Road, Jinan 250021, PR China. Electronic address: dujiajun568@163.com.

Abstract

OBJECTIVE:

The aim of our study was to compare the operative characteristics and long term survival for elderly patients with stage I non-small cell lung cancer (NSCLC) who underwent sublobectomy versus lobectomy.

METHODS:

We identified 245 consecutive elderly patients (≥65y) with pathologic stage I NSCLC who underwent lobectomy or sublobectomy at our institution between 2006 and 2012, and assessed the operative characteristics, recurrence, and survival differences between these approaches.

RESULTS:

A total of 39 patients underwent sublobectomy and 206 patients had lobectomy. There were significantly more COPD (p = 0.046) and low percent of predicted FEV1 (p = 0.034) in sublobectomy patients compared to the lobectomy group. Sublobectomy patients had significantly shorter operating time (p = 0.001), less blood loss (p = 0.000), and trended toward fewer chest tube days (p = 0.001) and shorter hospital length of stay (p = 0.030). The 1-, 3-, and 5-year survival rates in patients with lobectomy were 91.3, 77.7, and 64.1%, respectively, and has no significantly difference with those underwent sublobectomy (87.2, 74.4, and 61.5%, respectively, p = 0.623). Subgroups survival analysis showed no significant difference in the OS and DFS for patients with T < 2 cm or %FEV1<80%, but survival after sublobectomy was worse if performed on patients with larger tumours (T ≥ 2 cm) or relatively strong lung function (%FEV1≥80%).

CONCLUSION:

We concluded that sublobectomy might achieve similar survival rates when compared with lobectomy in elderly stage I NSCLC patients, especially for patients with low %FEV1 and stage IA tumours less than 2 cm in diameter.

KEYWORDS:

Elderly; Lobectomy; NSCLC; Segmentectomy; Wedge resection

PMID:
27890654
DOI:
10.1016/j.ijsu.2016.11.090
[Indexed for MEDLINE]
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