Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma
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 st...
Gespeichert in:
| Veröffentlicht in: | European journal of cardio-thoracic surgery 2024-07, Vol.66 (1) |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 1 |
| container_start_page | |
| container_title | European journal of cardio-thoracic surgery |
| container_volume | 66 |
| creator | Thomas, Pascal Alexandre Seguin-Givelet, Agathe Pages, Pierre-Benoît Alifano, Marco Brouchet, Laurent Falcoz, Pierre-Emmanuel Baste, Jean-Marc Glorion, Matthieu Belaroussi, Yaniss Filaire, Marc Heyndrickx, Maxime Loundou, Anderson Fourdrain, Alex Dahan, Marcel Boyer, Laurent |
| description | 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 |
| doi_str_mv | 10.1093/ejcts/ezae251 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_04826700v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ejcts/ezae251</oup_id><sourcerecordid>3072292246</sourcerecordid><originalsourceid>FETCH-LOGICAL-c246t-e588371bebbb6affe183dbb9a54699e9664ce62f4ff0ec05e5e73baef65303c33</originalsourceid><addsrcrecordid>eNqFkdtLwzAUh4Mo3h99lTwqWE2aNmkfx_AGA0EUfAtJerJ1tM1MUsf86-3c1EefzoWP7xz4IXRGyTUlJbuBuYnhBj4VpDndQYe0ECwRLHvbHXpCSSLKjBygoxDmhBDOUrGPDlhRUpFReoj8M6gmWTrfVNj10bgWAnYWN06Dia5dXeEA0xa6uBmx6iq8hGoK2EMYdrXrsHUexxng6EHFNbs2hKgGyCSPI9z03RQb5U3duVadoD2rmgCn23qMXu9uX8YPyeTp_nE8miQmzXhMIC8KJqgGrTVX1gItWKV1qfKMlyWUnGcGeGozawkYkkMOgmkFlueMMMPYMbrceGeqkQtft8qvpFO1fBhN5HpHsiLlgpAPOrAXG3bh3XsPIcq2DgaaRnXg-iAZEWlapsNjA5psUONdCB7sr5sSuY5Efkcit5EM_PlW3esWql_6J4O_265f_OP6AtUHmIQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3072292246</pqid></control><display><type>article</type><title>Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma</title><source>Oxford University Press Journals Current</source><creator>Thomas, Pascal Alexandre ; Seguin-Givelet, Agathe ; Pages, Pierre-Benoît ; Alifano, Marco ; Brouchet, Laurent ; Falcoz, Pierre-Emmanuel ; Baste, Jean-Marc ; Glorion, Matthieu ; Belaroussi, Yaniss ; Filaire, Marc ; Heyndrickx, Maxime ; Loundou, Anderson ; Fourdrain, Alex ; Dahan, Marcel ; Boyer, Laurent</creator><creatorcontrib>Thomas, Pascal Alexandre ; Seguin-Givelet, Agathe ; Pages, Pierre-Benoît ; Alifano, Marco ; Brouchet, Laurent ; Falcoz, Pierre-Emmanuel ; Baste, Jean-Marc ; Glorion, Matthieu ; Belaroussi, Yaniss ; Filaire, Marc ; Heyndrickx, Maxime ; Loundou, Anderson ; Fourdrain, Alex ; Dahan, Marcel ; Boyer, Laurent ; EPITHOR working group</creatorcontrib><description>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.
In 2 recent multicentre randomized controlled studies [1, 2], sublobar resection was found to be noninferior to lobectomy in terms of disease-free and overall survival.
Graphical Abstract</description><identifier>ISSN: 1010-7940</identifier><identifier>ISSN: 1873-734X</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezae251</identifier><identifier>PMID: 38917411</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Cancer ; Human health and pathology ; Life Sciences ; Surgery</subject><ispartof>European journal of cardio-thoracic surgery, 2024-07, Vol.66 (1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c246t-e588371bebbb6affe183dbb9a54699e9664ce62f4ff0ec05e5e73baef65303c33</cites><orcidid>0000-0002-2906-4433 ; 0000-0002-1739-4523 ; 0000-0003-4301-9476 ; 0000-0002-2038-1037 ; 0000-0002-3305-6989 ; 0000-0002-3233-860X ; 0000-0001-6431-3899 ; 0000-0001-7654-474X ; 0009-0000-1189-9849</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38917411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://uca.hal.science/hal-04826700$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Thomas, Pascal Alexandre</creatorcontrib><creatorcontrib>Seguin-Givelet, Agathe</creatorcontrib><creatorcontrib>Pages, Pierre-Benoît</creatorcontrib><creatorcontrib>Alifano, Marco</creatorcontrib><creatorcontrib>Brouchet, Laurent</creatorcontrib><creatorcontrib>Falcoz, Pierre-Emmanuel</creatorcontrib><creatorcontrib>Baste, Jean-Marc</creatorcontrib><creatorcontrib>Glorion, Matthieu</creatorcontrib><creatorcontrib>Belaroussi, Yaniss</creatorcontrib><creatorcontrib>Filaire, Marc</creatorcontrib><creatorcontrib>Heyndrickx, Maxime</creatorcontrib><creatorcontrib>Loundou, Anderson</creatorcontrib><creatorcontrib>Fourdrain, Alex</creatorcontrib><creatorcontrib>Dahan, Marcel</creatorcontrib><creatorcontrib>Boyer, Laurent</creatorcontrib><creatorcontrib>EPITHOR working group</creatorcontrib><title>Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>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.
In 2 recent multicentre randomized controlled studies [1, 2], sublobar resection was found to be noninferior to lobectomy in terms of disease-free and overall survival.
Graphical Abstract</description><subject>Cancer</subject><subject>Human health and pathology</subject><subject>Life Sciences</subject><subject>Surgery</subject><issn>1010-7940</issn><issn>1873-734X</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkdtLwzAUh4Mo3h99lTwqWE2aNmkfx_AGA0EUfAtJerJ1tM1MUsf86-3c1EefzoWP7xz4IXRGyTUlJbuBuYnhBj4VpDndQYe0ECwRLHvbHXpCSSLKjBygoxDmhBDOUrGPDlhRUpFReoj8M6gmWTrfVNj10bgWAnYWN06Dia5dXeEA0xa6uBmx6iq8hGoK2EMYdrXrsHUexxng6EHFNbs2hKgGyCSPI9z03RQb5U3duVadoD2rmgCn23qMXu9uX8YPyeTp_nE8miQmzXhMIC8KJqgGrTVX1gItWKV1qfKMlyWUnGcGeGozawkYkkMOgmkFlueMMMPYMbrceGeqkQtft8qvpFO1fBhN5HpHsiLlgpAPOrAXG3bh3XsPIcq2DgaaRnXg-iAZEWlapsNjA5psUONdCB7sr5sSuY5Efkcit5EM_PlW3esWql_6J4O_265f_OP6AtUHmIQ</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Thomas, Pascal Alexandre</creator><creator>Seguin-Givelet, Agathe</creator><creator>Pages, Pierre-Benoît</creator><creator>Alifano, Marco</creator><creator>Brouchet, Laurent</creator><creator>Falcoz, Pierre-Emmanuel</creator><creator>Baste, Jean-Marc</creator><creator>Glorion, Matthieu</creator><creator>Belaroussi, Yaniss</creator><creator>Filaire, Marc</creator><creator>Heyndrickx, Maxime</creator><creator>Loundou, Anderson</creator><creator>Fourdrain, Alex</creator><creator>Dahan, Marcel</creator><creator>Boyer, Laurent</creator><general>Oxford University Press</general><general>Oxford University Press (OUP)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-2906-4433</orcidid><orcidid>https://orcid.org/0000-0002-1739-4523</orcidid><orcidid>https://orcid.org/0000-0003-4301-9476</orcidid><orcidid>https://orcid.org/0000-0002-2038-1037</orcidid><orcidid>https://orcid.org/0000-0002-3305-6989</orcidid><orcidid>https://orcid.org/0000-0002-3233-860X</orcidid><orcidid>https://orcid.org/0000-0001-6431-3899</orcidid><orcidid>https://orcid.org/0000-0001-7654-474X</orcidid><orcidid>https://orcid.org/0009-0000-1189-9849</orcidid></search><sort><creationdate>20240701</creationdate><title>Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma</title><author>Thomas, Pascal Alexandre ; Seguin-Givelet, Agathe ; Pages, Pierre-Benoît ; Alifano, Marco ; Brouchet, Laurent ; Falcoz, Pierre-Emmanuel ; Baste, Jean-Marc ; Glorion, Matthieu ; Belaroussi, Yaniss ; Filaire, Marc ; Heyndrickx, Maxime ; Loundou, Anderson ; Fourdrain, Alex ; Dahan, Marcel ; Boyer, Laurent</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c246t-e588371bebbb6affe183dbb9a54699e9664ce62f4ff0ec05e5e73baef65303c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cancer</topic><topic>Human health and pathology</topic><topic>Life Sciences</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Pascal Alexandre</creatorcontrib><creatorcontrib>Seguin-Givelet, Agathe</creatorcontrib><creatorcontrib>Pages, Pierre-Benoît</creatorcontrib><creatorcontrib>Alifano, Marco</creatorcontrib><creatorcontrib>Brouchet, Laurent</creatorcontrib><creatorcontrib>Falcoz, Pierre-Emmanuel</creatorcontrib><creatorcontrib>Baste, Jean-Marc</creatorcontrib><creatorcontrib>Glorion, Matthieu</creatorcontrib><creatorcontrib>Belaroussi, Yaniss</creatorcontrib><creatorcontrib>Filaire, Marc</creatorcontrib><creatorcontrib>Heyndrickx, Maxime</creatorcontrib><creatorcontrib>Loundou, Anderson</creatorcontrib><creatorcontrib>Fourdrain, Alex</creatorcontrib><creatorcontrib>Dahan, Marcel</creatorcontrib><creatorcontrib>Boyer, Laurent</creatorcontrib><creatorcontrib>EPITHOR working group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Pascal Alexandre</au><au>Seguin-Givelet, Agathe</au><au>Pages, Pierre-Benoît</au><au>Alifano, Marco</au><au>Brouchet, Laurent</au><au>Falcoz, Pierre-Emmanuel</au><au>Baste, Jean-Marc</au><au>Glorion, Matthieu</au><au>Belaroussi, Yaniss</au><au>Filaire, Marc</au><au>Heyndrickx, Maxime</au><au>Loundou, Anderson</au><au>Fourdrain, Alex</au><au>Dahan, Marcel</au><au>Boyer, Laurent</au><aucorp>EPITHOR working group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>66</volume><issue>1</issue><issn>1010-7940</issn><issn>1873-734X</issn><eissn>1873-734X</eissn><abstract>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.
In 2 recent multicentre randomized controlled studies [1, 2], sublobar resection was found to be noninferior to lobectomy in terms of disease-free and overall survival.
Graphical Abstract</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>38917411</pmid><doi>10.1093/ejcts/ezae251</doi><orcidid>https://orcid.org/0000-0002-2906-4433</orcidid><orcidid>https://orcid.org/0000-0002-1739-4523</orcidid><orcidid>https://orcid.org/0000-0003-4301-9476</orcidid><orcidid>https://orcid.org/0000-0002-2038-1037</orcidid><orcidid>https://orcid.org/0000-0002-3305-6989</orcidid><orcidid>https://orcid.org/0000-0002-3233-860X</orcidid><orcidid>https://orcid.org/0000-0001-6431-3899</orcidid><orcidid>https://orcid.org/0000-0001-7654-474X</orcidid><orcidid>https://orcid.org/0009-0000-1189-9849</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1010-7940 |
| ispartof | European journal of cardio-thoracic surgery, 2024-07, Vol.66 (1) |
| issn | 1010-7940 1873-734X 1873-734X |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_04826700v1 |
| source | Oxford University Press Journals Current |
| subjects | Cancer Human health and pathology Life Sciences Surgery |
| title | Real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage c-IA lung carcinoma |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T21%3A02%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Real-world%20outcomes%20of%20lobectomy,%20segmentectomy%20and%20wedge%20resection%20for%20the%20treatment%20of%20stage%20c-IA%20lung%20carcinoma&rft.jtitle=European%20journal%20of%20cardio-thoracic%20surgery&rft.au=Thomas,%20Pascal%20Alexandre&rft.aucorp=EPITHOR%20working%20group&rft.date=2024-07-01&rft.volume=66&rft.issue=1&rft.issn=1010-7940&rft.eissn=1873-734X&rft_id=info:doi/10.1093/ejcts/ezae251&rft_dat=%3Cproquest_hal_p%3E3072292246%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3072292246&rft_id=info:pmid/38917411&rft_oup_id=10.1093/ejcts/ezae251&rfr_iscdi=true |