Limited resection for stage IA radiologically invasive lung cancer: a real-world nationwide database study
Abstract OBJECTIVES Radiologically invasive non-small-cell lung cancer, defined as consolidation size to maximum tumour diameter ratio of over 0.5, is associated with pathological invasiveness and worse prognosis. However, there are no real-world, nationwide database studies on limited resections th...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2022-06, Vol.62 (1) |
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| creator | Soh, Junichi Toyooka, Shinichi Shintani, Yasushi Okami, Jiro Ito, Hiroyuki Ohtsuka, Takashi Mori, Takeshi Watanabe, Shun-Ichi Asamura, Hisao Chida, Masayuki Endo, Shunsuke Nakanishi, Ryoichi Kadokura, Mitsutaka Suzuki, Hidemi Miyaoka, Etsuo Yoshino, Ichiro Date, Hiroshi |
| description | Abstract
OBJECTIVES
Radiologically invasive non-small-cell lung cancer, defined as consolidation size to maximum tumour diameter ratio of over 0.5, is associated with pathological invasiveness and worse prognosis. However, there are no real-world, nationwide database studies on limited resections that consider radiological invasiveness. This study aimed to investigate the prognostic validity of limited resection, such as segmentectomy and wedge resection, in cStage IA (TNM 8th edition) radiologically invasive lung cancer.
METHODS
We conducted a retrospective analysis of patients who underwent complete resection according to the Japanese Joint Committee of Lung Cancer Registry Database. The relationship between surgical procedures and prognosis was examined using stratification by cT factor and radiological invasiveness.
RESULTS
Among the 5,692 patients enrolled, lobectomy, segmentectomy and wedge resection were performed in 4,323 (80.0%), 657 (11.5%) and 712 (12.5%) patients, respectively. Multivariable analysis with or without propensity score matching indicated that older age, poor performance status and wedge resection were significantly associated with worse prognosis and that patients who underwent segmentectomy showed an equivalent prognosis to those who underwent lobectomy. Subset analyses revealed that segmentectomy showed an equivalent prognosis to lobectomy in patients with cT1b or less, but not in those with cT1c, especially for non-pure radiological invasive cT1c; 5-year overall survival rates were 91.4% vs 90.4% in cT1b with non-pure radiological invasiveness and 80.0% vs 83.8% in cT1b with pure radiological invasiveness, respectively.
CONCLUSIONS
Segmentectomy can be an alternative to lobectomy in patients with radiologically invasive lung cancer with cT1b or less but not in those with cT1c.
Lung cancer is the leading cause of death from cancer worldwide, and the number of patients is increasing [1]. |
| doi_str_mv | 10.1093/ejcts/ezac342 |
| format | Article |
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OBJECTIVES
Radiologically invasive non-small-cell lung cancer, defined as consolidation size to maximum tumour diameter ratio of over 0.5, is associated with pathological invasiveness and worse prognosis. However, there are no real-world, nationwide database studies on limited resections that consider radiological invasiveness. This study aimed to investigate the prognostic validity of limited resection, such as segmentectomy and wedge resection, in cStage IA (TNM 8th edition) radiologically invasive lung cancer.
METHODS
We conducted a retrospective analysis of patients who underwent complete resection according to the Japanese Joint Committee of Lung Cancer Registry Database. The relationship between surgical procedures and prognosis was examined using stratification by cT factor and radiological invasiveness.
RESULTS
Among the 5,692 patients enrolled, lobectomy, segmentectomy and wedge resection were performed in 4,323 (80.0%), 657 (11.5%) and 712 (12.5%) patients, respectively. Multivariable analysis with or without propensity score matching indicated that older age, poor performance status and wedge resection were significantly associated with worse prognosis and that patients who underwent segmentectomy showed an equivalent prognosis to those who underwent lobectomy. Subset analyses revealed that segmentectomy showed an equivalent prognosis to lobectomy in patients with cT1b or less, but not in those with cT1c, especially for non-pure radiological invasive cT1c; 5-year overall survival rates were 91.4% vs 90.4% in cT1b with non-pure radiological invasiveness and 80.0% vs 83.8% in cT1b with pure radiological invasiveness, respectively.
CONCLUSIONS
Segmentectomy can be an alternative to lobectomy in patients with radiologically invasive lung cancer with cT1b or less but not in those with cT1c.
Lung cancer is the leading cause of death from cancer worldwide, and the number of patients is increasing [1].</description><identifier>ISSN: 1873-734X</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezac342</identifier><identifier>PMID: 35678584</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><ispartof>European journal of cardio-thoracic surgery, 2022-06, Vol.62 (1)</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3821-99a6488df2cee7c90baeb3ad1b2025e58d207f39bb0135a1a73a89ba11db9ae03</citedby><cites>FETCH-LOGICAL-c3821-99a6488df2cee7c90baeb3ad1b2025e58d207f39bb0135a1a73a89ba11db9ae03</cites><orcidid>0000-0001-8532-7915 ; 0000-0002-8983-433X ; 0000-0001-8502-1502 ; 0000-0003-0983-6093 ; 0000-0001-7262-6000 ; 0000-0002-2540-5288 ; 0000-0002-7588-6745</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35678584$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soh, Junichi</creatorcontrib><creatorcontrib>Toyooka, Shinichi</creatorcontrib><creatorcontrib>Shintani, Yasushi</creatorcontrib><creatorcontrib>Okami, Jiro</creatorcontrib><creatorcontrib>Ito, Hiroyuki</creatorcontrib><creatorcontrib>Ohtsuka, Takashi</creatorcontrib><creatorcontrib>Mori, Takeshi</creatorcontrib><creatorcontrib>Watanabe, Shun-Ichi</creatorcontrib><creatorcontrib>Asamura, Hisao</creatorcontrib><creatorcontrib>Chida, Masayuki</creatorcontrib><creatorcontrib>Endo, Shunsuke</creatorcontrib><creatorcontrib>Nakanishi, Ryoichi</creatorcontrib><creatorcontrib>Kadokura, Mitsutaka</creatorcontrib><creatorcontrib>Suzuki, Hidemi</creatorcontrib><creatorcontrib>Miyaoka, Etsuo</creatorcontrib><creatorcontrib>Yoshino, Ichiro</creatorcontrib><creatorcontrib>Date, Hiroshi</creatorcontrib><creatorcontrib>Japanese Joint Committee of Lung Cancer Registry</creatorcontrib><title>Limited resection for stage IA radiologically invasive lung cancer: a real-world nationwide database study</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract
OBJECTIVES
Radiologically invasive non-small-cell lung cancer, defined as consolidation size to maximum tumour diameter ratio of over 0.5, is associated with pathological invasiveness and worse prognosis. However, there are no real-world, nationwide database studies on limited resections that consider radiological invasiveness. This study aimed to investigate the prognostic validity of limited resection, such as segmentectomy and wedge resection, in cStage IA (TNM 8th edition) radiologically invasive lung cancer.
METHODS
We conducted a retrospective analysis of patients who underwent complete resection according to the Japanese Joint Committee of Lung Cancer Registry Database. The relationship between surgical procedures and prognosis was examined using stratification by cT factor and radiological invasiveness.
RESULTS
Among the 5,692 patients enrolled, lobectomy, segmentectomy and wedge resection were performed in 4,323 (80.0%), 657 (11.5%) and 712 (12.5%) patients, respectively. Multivariable analysis with or without propensity score matching indicated that older age, poor performance status and wedge resection were significantly associated with worse prognosis and that patients who underwent segmentectomy showed an equivalent prognosis to those who underwent lobectomy. Subset analyses revealed that segmentectomy showed an equivalent prognosis to lobectomy in patients with cT1b or less, but not in those with cT1c, especially for non-pure radiological invasive cT1c; 5-year overall survival rates were 91.4% vs 90.4% in cT1b with non-pure radiological invasiveness and 80.0% vs 83.8% in cT1b with pure radiological invasiveness, respectively.
CONCLUSIONS
Segmentectomy can be an alternative to lobectomy in patients with radiologically invasive lung cancer with cT1b or less but not in those with cT1c.
Lung cancer is the leading cause of death from cancer worldwide, and the number of patients is increasing [1].</description><issn>1873-734X</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNqFkDtPwzAQgC0EgvIYWZFHllA7TuKEDVW8pEosILFFZ_tSuXLjYidU5deT0vLYmO6G776TPkLOObvirBJjnOsujvEDtMjSPTLipRSJFNnr_p_9iBzHOGeMFSKVh-RI5IUs8zIbkfnULmyHhgaMqDvrW9r4QGMHM6SPNzSAsd75mdXg3Jra9h2ifUfq-nZGNbQawzWF4RpcsvLBGdrCxrKyBqmBDhREHHS9WZ-SgwZcxLPdPCEvd7fPk4dk-nT_OLmZJlqUKU-qCoqsLE2TakSpK6YAlQDDVcrSHPPSpEw2olKKcZEDBymgrBRwblQFyMQJudx6l8G_9Ri7emGjRuegRd_HOi1kJvO8EMWAJltUBx9jwKZeBruAsK45qzd566-89S7vwF_s1L1aoPmhv3v-_vb98h_XJzY5h_o</recordid><startdate>20220615</startdate><enddate>20220615</enddate><creator>Soh, Junichi</creator><creator>Toyooka, Shinichi</creator><creator>Shintani, Yasushi</creator><creator>Okami, Jiro</creator><creator>Ito, Hiroyuki</creator><creator>Ohtsuka, Takashi</creator><creator>Mori, Takeshi</creator><creator>Watanabe, Shun-Ichi</creator><creator>Asamura, Hisao</creator><creator>Chida, Masayuki</creator><creator>Endo, Shunsuke</creator><creator>Nakanishi, Ryoichi</creator><creator>Kadokura, Mitsutaka</creator><creator>Suzuki, Hidemi</creator><creator>Miyaoka, Etsuo</creator><creator>Yoshino, Ichiro</creator><creator>Date, Hiroshi</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8532-7915</orcidid><orcidid>https://orcid.org/0000-0002-8983-433X</orcidid><orcidid>https://orcid.org/0000-0001-8502-1502</orcidid><orcidid>https://orcid.org/0000-0003-0983-6093</orcidid><orcidid>https://orcid.org/0000-0001-7262-6000</orcidid><orcidid>https://orcid.org/0000-0002-2540-5288</orcidid><orcidid>https://orcid.org/0000-0002-7588-6745</orcidid></search><sort><creationdate>20220615</creationdate><title>Limited resection for stage IA radiologically invasive lung cancer: a real-world nationwide database study</title><author>Soh, Junichi ; Toyooka, Shinichi ; Shintani, Yasushi ; Okami, Jiro ; Ito, Hiroyuki ; Ohtsuka, Takashi ; Mori, Takeshi ; Watanabe, Shun-Ichi ; Asamura, Hisao ; Chida, Masayuki ; Endo, Shunsuke ; Nakanishi, Ryoichi ; Kadokura, Mitsutaka ; Suzuki, Hidemi ; Miyaoka, Etsuo ; Yoshino, Ichiro ; Date, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3821-99a6488df2cee7c90baeb3ad1b2025e58d207f39bb0135a1a73a89ba11db9ae03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soh, Junichi</creatorcontrib><creatorcontrib>Toyooka, Shinichi</creatorcontrib><creatorcontrib>Shintani, Yasushi</creatorcontrib><creatorcontrib>Okami, Jiro</creatorcontrib><creatorcontrib>Ito, Hiroyuki</creatorcontrib><creatorcontrib>Ohtsuka, Takashi</creatorcontrib><creatorcontrib>Mori, Takeshi</creatorcontrib><creatorcontrib>Watanabe, Shun-Ichi</creatorcontrib><creatorcontrib>Asamura, Hisao</creatorcontrib><creatorcontrib>Chida, Masayuki</creatorcontrib><creatorcontrib>Endo, Shunsuke</creatorcontrib><creatorcontrib>Nakanishi, Ryoichi</creatorcontrib><creatorcontrib>Kadokura, Mitsutaka</creatorcontrib><creatorcontrib>Suzuki, Hidemi</creatorcontrib><creatorcontrib>Miyaoka, Etsuo</creatorcontrib><creatorcontrib>Yoshino, Ichiro</creatorcontrib><creatorcontrib>Date, Hiroshi</creatorcontrib><creatorcontrib>Japanese Joint Committee of Lung Cancer Registry</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soh, Junichi</au><au>Toyooka, Shinichi</au><au>Shintani, Yasushi</au><au>Okami, Jiro</au><au>Ito, Hiroyuki</au><au>Ohtsuka, Takashi</au><au>Mori, Takeshi</au><au>Watanabe, Shun-Ichi</au><au>Asamura, Hisao</au><au>Chida, Masayuki</au><au>Endo, Shunsuke</au><au>Nakanishi, Ryoichi</au><au>Kadokura, Mitsutaka</au><au>Suzuki, Hidemi</au><au>Miyaoka, Etsuo</au><au>Yoshino, Ichiro</au><au>Date, Hiroshi</au><aucorp>Japanese Joint Committee of Lung Cancer Registry</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limited resection for stage IA radiologically invasive lung cancer: a real-world nationwide database study</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2022-06-15</date><risdate>2022</risdate><volume>62</volume><issue>1</issue><issn>1873-734X</issn><eissn>1873-734X</eissn><abstract>Abstract
OBJECTIVES
Radiologically invasive non-small-cell lung cancer, defined as consolidation size to maximum tumour diameter ratio of over 0.5, is associated with pathological invasiveness and worse prognosis. However, there are no real-world, nationwide database studies on limited resections that consider radiological invasiveness. This study aimed to investigate the prognostic validity of limited resection, such as segmentectomy and wedge resection, in cStage IA (TNM 8th edition) radiologically invasive lung cancer.
METHODS
We conducted a retrospective analysis of patients who underwent complete resection according to the Japanese Joint Committee of Lung Cancer Registry Database. The relationship between surgical procedures and prognosis was examined using stratification by cT factor and radiological invasiveness.
RESULTS
Among the 5,692 patients enrolled, lobectomy, segmentectomy and wedge resection were performed in 4,323 (80.0%), 657 (11.5%) and 712 (12.5%) patients, respectively. Multivariable analysis with or without propensity score matching indicated that older age, poor performance status and wedge resection were significantly associated with worse prognosis and that patients who underwent segmentectomy showed an equivalent prognosis to those who underwent lobectomy. Subset analyses revealed that segmentectomy showed an equivalent prognosis to lobectomy in patients with cT1b or less, but not in those with cT1c, especially for non-pure radiological invasive cT1c; 5-year overall survival rates were 91.4% vs 90.4% in cT1b with non-pure radiological invasiveness and 80.0% vs 83.8% in cT1b with pure radiological invasiveness, respectively.
CONCLUSIONS
Segmentectomy can be an alternative to lobectomy in patients with radiologically invasive lung cancer with cT1b or less but not in those with cT1c.
Lung cancer is the leading cause of death from cancer worldwide, and the number of patients is increasing [1].</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>35678584</pmid><doi>10.1093/ejcts/ezac342</doi><orcidid>https://orcid.org/0000-0001-8532-7915</orcidid><orcidid>https://orcid.org/0000-0002-8983-433X</orcidid><orcidid>https://orcid.org/0000-0001-8502-1502</orcidid><orcidid>https://orcid.org/0000-0003-0983-6093</orcidid><orcidid>https://orcid.org/0000-0001-7262-6000</orcidid><orcidid>https://orcid.org/0000-0002-2540-5288</orcidid><orcidid>https://orcid.org/0000-0002-7588-6745</orcidid><oa>free_for_read</oa></addata></record> |
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| title | Limited resection for stage IA radiologically invasive lung cancer: a real-world nationwide database study |
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