TY - JOUR
T1 - Wedge resection vs lobectomy
T2 - 10-Year survival in stage I primary lung cancer
AU - Kraev, Alexander
AU - Rassias, Dennis
AU - Vetto, John
AU - Torosoff, Mikhail
AU - Ravichandran, Pasala
AU - Clement, Christina
AU - Kadri, Adebambo
AU - Ilves, Riivo
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2007/1
Y1 - 2007/1
N2 - Background: The selection of lobectomy or wedge resection in the treatment of patients with stage I primary lung cancer remains controversial. Clinical judgment based on comorbidities remains the main decision factor. We investigated the impact of procedure on long-term survival in a multicenter retrospective analysis. Methods: The records of 289 patients who underwent surgical resection of stage I primary lung cancer between 1993 and 1998 at three tertiary medical centers were reviewed for age, sex, type of resection, tumor size, number of lymph nodes dissected, pathology, and recurrence. Long-term survival was obtained through the Federal Social Security Death Index and Cancer Registries. Kaplan-Meier, Wilcox, logistic regression, and power and t test analyses were used to examine survival, predictors of mortality, and correlations. Results: A total of 215 patients underwent lobectomy, and 74 underwent wedge resection. The groups were similar with respect to age, tumor size, and other comorbidities. Overall, there was a nonsignificant trend toward better survival times in patients after lobectomy vs wedge resection (mean [± SD] survival time, 5.8 ± 0.3 vs 4.1 ± 0.3 years, respectively; p = 0.112). This trend gained significance in smaller cancers, where patients who underwent lobectomy for tumors < 3 cm in size had better survival times compared to those who underwent wedge resection (p = 0.029). Conclusion: Although the overall difference in survival time between patients undergoing lobectomy and those undergoing wedge resection was not significant, patients with tumors < 3 cm in size had improved survival times after undergoing lobectomy. Thus, tumor size appears to be an important factor to be considered in preoperative planning. Randomized trials are necessary to confirm the superiority of lobectomy over wedge resection for stage IA lung cancers.
AB - Background: The selection of lobectomy or wedge resection in the treatment of patients with stage I primary lung cancer remains controversial. Clinical judgment based on comorbidities remains the main decision factor. We investigated the impact of procedure on long-term survival in a multicenter retrospective analysis. Methods: The records of 289 patients who underwent surgical resection of stage I primary lung cancer between 1993 and 1998 at three tertiary medical centers were reviewed for age, sex, type of resection, tumor size, number of lymph nodes dissected, pathology, and recurrence. Long-term survival was obtained through the Federal Social Security Death Index and Cancer Registries. Kaplan-Meier, Wilcox, logistic regression, and power and t test analyses were used to examine survival, predictors of mortality, and correlations. Results: A total of 215 patients underwent lobectomy, and 74 underwent wedge resection. The groups were similar with respect to age, tumor size, and other comorbidities. Overall, there was a nonsignificant trend toward better survival times in patients after lobectomy vs wedge resection (mean [± SD] survival time, 5.8 ± 0.3 vs 4.1 ± 0.3 years, respectively; p = 0.112). This trend gained significance in smaller cancers, where patients who underwent lobectomy for tumors < 3 cm in size had better survival times compared to those who underwent wedge resection (p = 0.029). Conclusion: Although the overall difference in survival time between patients undergoing lobectomy and those undergoing wedge resection was not significant, patients with tumors < 3 cm in size had improved survival times after undergoing lobectomy. Thus, tumor size appears to be an important factor to be considered in preoperative planning. Randomized trials are necessary to confirm the superiority of lobectomy over wedge resection for stage IA lung cancers.
KW - Lobectomy
KW - Stage I lung cancer
KW - Survival
KW - Tumor size
KW - Wedge resection
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U2 - 10.1378/chest.06-0840
DO - 10.1378/chest.06-0840
M3 - Article
C2 - 17218567
AN - SCOPUS:33846307745
VL - 131
SP - 136
EP - 140
JO - Chest
JF - Chest
SN - 0012-3692
IS - 1
ER -