■使用先前未报告的秘鲁早期非小细胞肺癌(NSCLC)治疗患者注册,这项研究探讨了楔形切除术和肺叶切除术在生存率和对放射学-病理学变量的影响方面是否相等.
■这个观测,分析,纵向研究采用倾向评分匹配(PSM)分析,对2000~2020年期间接受楔形切除术(n=1,845)或肺叶切除术(n=725)的2,570例病理I~II期NSCLC患者进行单中心回顾性登记.PSM之后,650例分析(切除,n=325;肺叶切除术,n=325)通过术前和临床变量,包括≥1个淋巴结切除的患者。Kaplan-Meier曲线和多变量Cox比例风险模型用于5年总生存期(OS),无病生存率(DFS),和局部区域无复发生存率(LRFS)。
■主要并发症是肺叶切除术与楔形切除术持续7天的手术疼痛(58%与23%,p=0.034),切除的住院时间短于肺叶切除术(5.3天vs.12.8天,p=0.009)。5年OS(84.3%vs.81.2%,p=0.09)和DFS(79.1%与74.1%,p=0.07)在切除和肝切除术之间相似,统计学上无统计学意义,分别。楔形切除术后LRFS总体上比肺叶切除术差(79.8%vs.91.1%,p<0.02)。然而,在PSM分析中,当切除边缘>10mm时,两组都经历了相似的LRFS(90.9%vs.87.3%,p<0.048)和≥4个淋巴结切除(82.8%vs.79.1%,p<0.011)。
■这两种技术在5年后就产生了类似的OS和DFS;然而,成功的LRFS需要具有手术切缘的楔形切除术和足够的淋巴结切除才能获得与肺叶切除术相似的结果.
UNASSIGNED: Using a previously unreported Peruvian registry of patients treated for early-stage non-small cell lung cancer (NSCLC), this study explored whether wedge resection and lobectomy were equivalent regarding survival and impact on radiologic-pathologic variables.
UNASSIGNED: This observational, analytical, longitudinal study used propensity score-matched (PSM) analysis of a single-center retrospective registry of 2,570 patients with pathologic stage I-II NSCLC who were treated with wedge resection (n=1,845) or lobectomy (n=725) during 2000-2020. After PSM, 650 cases were analyzed (resection, n=325; lobectomy, n=325) through preoperative and clinical variables, including patients with ≥1 lymph node removed. Kaplan-Meier curves and multivariable Cox proportional hazard models were created for 5-year overall survival (OS), disease-free survival (DFS), and locoregional-recurrence-free survival (LRFS).
UNASSIGNED: The principal complication was operative pain persisting >7 days for lobectomy versus wedge resection (58% vs. 23%, p=0.034) and shorter hospital stays for resection than for lobectomy (5.3 days vs. 12.8 days, p=0.009). The 5-year OS (84.3% vs. 81.2%, p=0.09) and DFS (79.1% vs. 74.1%, p=0.07) were similar and statistically insignificant between resections and lobectomies, respectively. LRFS was worse overall following wedge resection than lobectomy (79.8% vs. 91.1%, p<0.02). Nevertheless, in the PSM analysis, both groups experienced similar LRFS when the resection margin was >10 mm (90.9% vs. 87.3%, p<0.048) and ≥4 lymph nodes were removed (82.8% vs. 79.1%, p<0.011).
UNASSIGNED: Both techniques led to similar OS and DFS at 5 years; however, successful LRFS required a wedge resection with a surgical margin and adequate lymph node removal to obtain outcomes similar to lobectomy.